# Mapping Neurocognitive Complications of Pediatric Type 1 Diabetes (T1D) and Potential Risk and Protective Factors

> **NIH NIH U01** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2024 · $269,730

## Abstract

PROJECT SUMMARY
The pathophysiology of cognitive dysfunction in prepubertal children with Type 1 Diabetes
Mellitus (T1DM) is not understood. It is likely that hyperglycemia, hypoglycemia, vascular
disease, insulin resistance, and diabetic ketoacidosis (DKA) play important roles. However, the
absence of longitudinal studies in T1DM children and our lack of understanding of the
pathogenesis of neuronal defects limit our ability to prevent cognitive disability and identify and
treat those at highest risk. Despite preliminary evidence that T1DM is associated with alterations
in brain structure and function, major gaps remain in our knowledge about how T1DM impacts
the developing brain.
The overall premise of this project is that T1DM in children is associated with significant
neurocognitive and brain alterations and the risk of developing neurocognitive deficits
increases with both biological and psychosocial stress that ultimately delay/impede the
normal maturation of associative brain systems supporting attention, learning and
memory, executive and social cognition. Our hypothesis is that children with greater net
exposure to biological and psychosocial stress will have greater deficits in trajectory of brain
development underlying complex cognition.
Our multidisciplinary team of neuroimaging experts and endocrinologists will examine brain and
cognitive alterations in children with T1DM across three aims: Aim 1 will measure the
differential impact of age of T1DM diagnosis on brain structure, micro-organization, metabolism
and function and mental health. Aim 2 will Identify biological and psychosocial moderators and
Risk and Resilience factors. We will evaluate the impact of both biological stressors and social
determinants of health (e.g., SES, Education, Adversity exposure, rurality, access to healthcare
services, race, etc.) on neurocognitive function and maturation in children with T1DM. In Aim 3
we will develop a recruitment, retention and dissemination strategy to prepare for future clinical
trials that build a precision risk- and resilience-prediction model.
The findings from this observational study will bridge gaps in our understanding of the
development of neurocognitive dysfunction in T1DM. It will further inform key clinical targets to
address to ensure the optimal care of children with T1DM. The power of a larger network will
further allow the exploration of complex 2-way or even 3-way interactions between biological
and social determinants of health and neurofunctional outcomes in children with T1DM.

## Key facts

- **NIH application ID:** 10974858
- **Project number:** 1U01DK140764-01
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Aysenil Belger
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $269,730
- **Award type:** 1
- **Project period:** 2024-08-15 → 2029-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10974858

## Citation

> US National Institutes of Health, RePORTER application 10974858, Mapping Neurocognitive Complications of Pediatric Type 1 Diabetes (T1D) and Potential Risk and Protective Factors (1U01DK140764-01). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/10974858. Licensed CC0.

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