# Neurocognitive Complications of Pediatric Type 1 Diabetes: Identifying Modifiable Risk and Protective Factors

> **NIH NIH U01** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2024 · $319,227

## Abstract

PROJECT SUMMARY
Children with type 1 diabetes (T1D) have small but significant deficits in neurocognitive functioning compared
to their peers without diabetes, especially in the areas of memory, learning, and executive function skills.
Further, neuroimaging studies consistently observe differences in brain structures and brain development in
children with T1D, particularly brain white matter microstructure. These deficits in cognitive function negatively
affect children’s ability to manage diabetes effectively, increasing risk for poor glycemic outcomes and further
brain insults. Evidence suggests that factors such as diabetic ketoacidosis (DKA) at time of T1D onset and
exposure to chronic hyperglycemia or severe hypoglycemia may increase risk or severity of these deficits, but
findings are mixed, and many studies were limited by the inclusion of older adolescents or adults with T1D,
small, homogenous samples, or cross-sectional designs. Thus, a large prospective study of a diverse sample
of school-aged children newly diagnosed with T1D and a matched group of children without diabetes is needed
to identify modifiable risk and protective factors for neurocognitive complications in this population. We will
over-enroll children from minoritized racial and ethnic groups to understand factors that may contribute to
disparities in outcomes. As a Clinical Center, we will work with the Biostatistics Research Core, the NIDDK
Project Scientist, and the other centers to finalize the study protocol, including collection of neuroimaging,
neurocognitive, and glucose data, and development of neuroimaging harmonization plans. Our
multidisciplinary team includes a pediatric psychologist, a pediatric neurologist, a pediatric endocrinologist, and
a pediatric neuroradiologist, as well as experts in imaging science and harmonization of imaging data. The
Children’s Diabetes Program at Vanderbilt University Medical Center serves a large, diverse population of
children with T1D and has a strong history of multicenter collaborations with other pediatric diabetes centers.
Further, as recipients of a related U34 award, we engaged with community members, including caregivers of
children with T1D, to inform the study aims and protocol. The proposed project will assess hypothesized risk
factors (DKA at presentation, glycemic variability, adverse childhood experience, socioeconomic status), as
well as potentially modifiable protective factors (child sleep quality, caregiver distress, and use of diabetes
devices). In addition, we will optimize neuroimaging protocols and processing tools to allow for harmonization
of high-resolution neuroimaging data across sites and scanners for the most robust analysis. Reductions of
neuronal density and white matter integrity may be measured non-invasively via advanced MRI of the brain
methods. This project has the potential to influence standards of clinical care for children with T1D and to
pinpoint critical periods for prevention and inter...

## Key facts

- **NIH application ID:** 10974441
- **Project number:** 1U01DK140743-01
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** Sarah S Jaser
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $319,227
- **Award type:** 1
- **Project period:** 2024-08-15 → 2029-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10974441

## Citation

> US National Institutes of Health, RePORTER application 10974441, Neurocognitive Complications of Pediatric Type 1 Diabetes: Identifying Modifiable Risk and Protective Factors (1U01DK140743-01). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/10974441. Licensed CC0.

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