# Impact of Glucose Variability on Dynamic Cognitive Function in Youth with Type 1 Diabetes

> **NIH NIH K01** · WASHINGTON UNIVERSITY · 2024 · $119,598

## Abstract

PROJECT SUMMARY/ABSTRACT
Type 1 diabetes (T1D) is one of the most common chronic childhood diseases and has a rapidly rising
incidence and prevalence. Management of blood glucose is challenging and often leads to frequent and rapid
swings between normal, high, and low glucose. This glucose variability has recently been identified as an
independent risk factor for diabetic complications. One of the least studied and understood complications of
T1D is altered cognition and its relationship to glucose variability. As the brain uses a substantial amount of the
body’s glucose to support its functions, especially during dynamic periods of brain development, there are
strong biological reasons for the potential vulnerability of youth with T1D. Several studies have shown lower
cognitive scores in youth with T1D compared to their peers without T1D, and shown that poorer overall
glycemic control as indicated by severe glycemic events (e.g., diabetic ketoacidosis) and chronic
hyperglycemia, are associated with lower cognitive scores both acutely and long-term. However, these studies
we conducted in a controlled, optimized laboratory settings at a single time point. Little is still known about how
typical glucose fluctuations that occur daily in real-life settings affect cognitive function in the moment,
particularly dynamic cognitive skills that are sensitive to environmental or physical conditions of the individual
(e.g. sleep deprivation) and thus fluctuate throughout the day (e.g., working memory, processing speed).
Determining the relationship between glycemic fluctuations and dynamic cognitive function is critically
important in youth given that dynamic cognitive skills are fundamental for learning, integrating, and
using novel information in their daily lives. Understanding how these skills are affected in daily life, how
they relate to glycemic fluctuations, and any contributing factors, could motivate improvements in academic
accommodations and T1D treatment recommendations. Importantly, this work could also be expanded to
better understand the impact of glycemic variability on brain health throughout the lifespan in T1D and could be
translated to other forms of diabetes (e.g., type 2 diabetes, gestational diabetes). The primary goal of this study
is to determine if real-time, real-life glycemic variability predicts fluctuations in dynamic cognitive function in
youth with T1D. A secondary goal is to determine whether dynamic cognitive function in youth with T1D differs
from youth without T1D, independent of significant glycemic extremes. To address these questions, I will apply
a unique and innovative combination of continuous health and cognitive data collection methods, multivariate
time-series analyses, and machine learning models. This work, combined with a tailored career development
plan, will form the basis of my future work as an independent investigator, which will expand to address how
diabetes-related health behaviors (e.g., food choice) ...

## Key facts

- **NIH application ID:** 10909141
- **Project number:** 5K01DK131339-03
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** Mary Katherine Osborn Ray
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $119,598
- **Award type:** 5
- **Project period:** 2022-09-01 → 2027-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10909141

## Citation

> US National Institutes of Health, RePORTER application 10909141, Impact of Glucose Variability on Dynamic Cognitive Function in Youth with Type 1 Diabetes (5K01DK131339-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10909141. Licensed CC0.

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