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Age of Childhood Onset in Type 1 Diabetes and Functional Brain Connectivity in Midlife
Ryan JP, Aizenstein HJ,  Orchard TJ, Ryan CM, Saxton JA, Fine DF, Nunley KA and Rosano C
Psychosomatic Medicine, Published Online, 2015

People diagnosed with type 1 diabetes in later childhood have weaker brain connectivity in midlife compared to those who were diagnosed at earlier ages.  Dr. John Ryan, Assistant Professor of Psychiatry, is the lead author of the article reporting this finding in a recent special issue of the journal Psychosomatic Medicine focused on diabetes, obesity and the brain.  He also serves as the special guest editor for that issue.  Dr. Ryan collaborated with Drs. Caterina Rosano and Trevor Orchard from the University of Pittsburgh Graduate School of Public Health on this study. 

Participants were recruited from the Pittsburgh Epidemiology of Diabetes Complications Study. Sixty-six adults aged 32 to 58 years old who were diagnosed with type 1 diabetes before age 18 at Children?s Hospital of Pittsburgh between 1965 and 1980 participated in the study.   The participant group is one of the few in the country in which people with childhood onset type 1 diabetes have been followed throughout their lifespan. 

?Due to advances in treatments, people with type 1 diabetes are living longer, but we don?t yet understand how diabetes and aging interact in the brain,? Dr. Ryan noted. ?The mechanisms underlying these associations are not yet clear.  However, the relationship between age of diagnosis and connectivity was stronger in older participants, supporting a model of diabetes as accelerated aging.?  

?Other studies have shown an association between earlier onset type 1 diabetes and cognitive difficulties, so we expected to find that people with earlier age of onset would have weaker connections between brain regions,? said Dr. Ryan. ?But instead, we found that those who were diagnosed later in childhood had the weaker brain connections.?

The diagnosis of type 1 diabetes later in childhood may be associated with lower brain functional connectivity, particularly in those surviving into older ages. These alterations may be an early marker for subsequent cognitive decrements. Future studies are warranted to understand the pathways underlying these associations.

Contributors:
John Ryan, PhD, Howard J. Aizenstein, MD, PhD, Christopher M. Ryan, PhD (Department of Psychiatry, University of Pittsburgh School of Medicine) 

Trevor J. Orchard, MBBCh, M.Med.Sci., FAHA, FACE. Judith A. Saxton, PhD, David F. Fine, BS, Karen A. Nunley, PhD and Rosano, Caterina MD, MPH (Graduate School of Public Health, University of Pittsburgh)

This article appears in the journal Psychosomatic Medicine.  Click here to view the abstract.