The Keck School of Medicine of USC has launched a nationwide longitudinal study to investigate the impact of type 1 diabetes on brain development in children. The study, funded by a $2.7 million grant from the National Institutes of Health (NIH), will involve 12 research centers across the United States and aims to recruit over 1,000 children recently diagnosed with the condition.
Understanding the Impact of Type 1 Diabetes on Developing Brains
Type 1 diabetes has been associated with cognitive impairments in adults, particularly affecting working memory and executive function. However, the effects on children during critical developmental periods are not well understood. This study seeks to address this gap by examining how the disease and its management influence brain structure and function in young patients.
"What we really want to know is: In children newly diagnosed with type 1 diabetes, what are factors that may either accelerate or mitigate the risk of developing brain-related complications?" said Kathleen Alanna Page, MD, associate professor of medicine at USC and one of the principal investigators for the project.
A Diverse Cohort for Comprehensive Insights
The study design emphasizes the inclusion of participants from diverse racial, ethnic, and socioeconomic backgrounds, addressing a historical bias in type 1 diabetes research that has predominantly focused on white children. This inclusive approach aims to ensure that the findings are applicable to a broader population.
"We want to translate these insights into real-world opportunities that can help the greatest number of children with diabetes," Page emphasized.
Refining Clinical Guidelines and Therapeutic Approaches
The researchers anticipate that the study's findings will contribute to refining clinical guidelines for managing type 1 diabetes, particularly in determining optimal glucose levels for healthy brain development. The study may also suggest personalized therapeutic approaches, including adjustments in sleep, diet, and physical activity, tailored to individual patients' needs.
"All of that is going to be critically important in improving outcomes in children with diabetes and putting them on the trajectory for better health in the long term," Page noted.
Advanced Tools and Comprehensive Data Collection
The study will leverage advanced tools such as insulin pumps and continuous glucose monitors (CGMs), which have transformed type 1 diabetes management. CGMs provide detailed data on glucose level fluctuations throughout the day, allowing researchers to assess the amount of time individuals spend in high- and low-glucose states.
The study will also employ functional magnetic resonance imaging (fMRI) to non-invasively examine the structure and function of the children’s brains. In addition to brain imaging, the study will collect data on academic performance, memory, attention, and neurobehavioral factors such as anxiety and behavioral health.
Collaborative Effort Across Multiple Sites
As the project progresses, researchers from each of the participating study sites will collaborate to finalize a detailed study protocol before recruitment begins. Leading the study from the Southern California hub, Page will be joined by co-principal investigators Jennifer Raymond, MD, a pediatric endocrinologist at the Children’s Hospital Los Angeles, and Anny H. Xiang, PhD, director of biostatistics research at Kaiser Permanente Southern California. Other participating sites include the University of Minnesota; Washington University in St. Louis; the University of North Carolina at Chapel Hill; Indiana University-Purdue University Indianapolis; the University of Florida; New York University School of Medicine; the University of California, Davis; Vanderbilt University Medical Center; Joslin Diabetes Center; Nemours Children’s Clinic; and the University of Colorado Denver.
