The Scylla and Charybdis of glucose control in childhood type 1 diabetes?

Pediatric Diabetes
Alison D McNeilly, Rory J McCrimmon

Abstract

Glucose control in childhood type 1 diabetes is difficult and often characterized by significant glucose variability, including periods of prolonged hyperglycemia and intermittent episodes of hypoglycemia that can be severe. The brain of the developing child is thought to be more susceptible to metabolic insults because of its relatively high demand for glucose to fuel neuronal growth and differentiation. In this review we consider the impact of glucose variability, especially when associated with recurrent hypoglycemia, on long-term cognitive function in childhood type 1 diabetes. At present, this indicates a subtle effect of type 1 diabetes per se on a number of cognitive modalities. Within the population of children with type 1 diabetes, a history of severe hypoglycemia also appears to have an additional negative effect on cognitive function. However, interpretation of the literature is difficult in that the human studies draw largely from cross-sectional observational epidemiology while more basic work has used models that do not translate well into human disease. Moreover, it is likely to be many years before we will be able to clearly document the effects of recurrent hypoglycemia or chronic hyperglycemia on cognitive fun...Continue Reading

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Citations

May 5, 2016·Current Medical Research and Opinion·S FranchiniA Blasetti
Aug 16, 2016·Current Diabetes Reports·Dayna E McGill, Lynne L Levitsky
Jul 21, 2017·Pediatric Diabetes·Frida SundbergRagnar Hanas
Jan 31, 2020·Journal of Pediatric Gastroenterology and Nutrition·Madeleine AumarLaurent Michaud
Nov 4, 2016·Pediatric Diabetes·Sally A HustonRobin Southwood
Nov 14, 2019·Journal of Clinical Medicine·Phillip TrefzDagmar-Christiane Fischer
May 23, 2020·Journal of Pediatric Gastroenterology and Nutrition·Madeleine AumarLaurent Michaud
Jun 24, 2021·Metabolism Open·Valeria Tromba, Francesca Silvestri
Dec 3, 2016·Diabetes Spectrum : a Publication of the American Diabetes Association·Rachel M WassermanDavid D Schwartz

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