Acute Hyperglycemia and Spatial Working Memory in Adolescents With Type 1 Diabetes

Abstract

Objective: To investigate the effect of acute hyperglycemia on brain function in adolescents with type 1 diabetes (T1D).

Research design and methods: Twenty participants with T1D (aged 14.64 ± 1.78 years) and 20 age-matched healthy control subjects (aged 14.40 ± 2.82 years) performed two functional MRI sessions. Participants with T1D performed the first scanning session under euglycemic and the second under hyperglycemic clamp (20 mmol/L [360 mg/dL]).

Results: Lower spatial working memory (sWM) capacity during acute hyperglycemia and significant differences in activation of regions of interest during different stages of the sWM task (P = 0.014) were observed.

Conclusions: Acute hyperglycemia negatively affected sWM capacity in adolescents with T1D, which is relevant for daily functioning and academic performance.

Trial registration: ClinicalTrials.gov NCT03188757.

Figure 1

Differences in brain activation as assessed by functional MRI during the performance of the sWM task between adolescents with T1D and healthy control subjects. A shows a priori ROIs. B presents the change of activation in ROIs between first and second session in the group with T1D and the healthy control group. C presents change of activation in ROIs between the first and second session in the group with T1D and the healthy control group shown separately for each phase of working memory task and hemisphere. D presents mean time courses of activation in ROIs by group, hemisphere, and session, showing higher levels of activation in participants with T1D during euglycemia and a decrease of activation during hyperglycemia. AI, anterior insula; AIP, anterior intraparietal area; DLPFC, dorsolateral prefrontal cortex; FEF, frontal eye field; IFJ, inferior frontal junction; L, left; MIP, medial intraparietal area; MTL, medial temporal lobe; R, right; SMA, supplementary motor area.