Brain Changes in Kids With Diabetic Ketoacidosis
(HealthDay News) — Changes in brain morphology and function have been observed in children who have diabetic ketoacidosis (DKA) at the time of diagnosis of type 1 diabetes, according to research published in the June issue of Diabetes Care.
Fergus J. Cameron, MD, of the University of Melbourne in Australia, and colleagues performed magnetic resonance imaging and spectroscopy with cognitive assessment at various time points after diagnosis of type 1 diabetes in patients with (36 patients) and without (59 patients) DKA. Patients were aged 6–18 years.
The researchers found that, in patients with DKA, the greatest changes occurred in cerebral white matter, with increased total white matter volume and higher mean diffusivity in the frontal, temporal, and parietal white matter. Over the first six months, total white matter volume decreased. Total gray matter volume was lower at baseline and increased over six months. At baseline and at five days, mental state scores were lower in DKA patients. Changes in total and regional brain volumes over the first five days resolved, but they were associated with poorer delayed memory recall and poorer sustained and divided attention at six months. Predictors of neuroimaging and functional outcomes were age at the time of presentation and pH level.
"DKA at type 1 diabetes diagnosis results in morphologic and functional brain changes," the authors write. "These changes are associated with adverse neurocognitive outcomes in the medium term."