SYNOPSIS
Arguably the pre-eminent developmental task of childhood is to grow a good brain. Glucose is the primary metabolic fuel for the brain- peaking at 140-170 grams per day at around 5 years of age with a constant supply critical for normal cerebral metabolism. Thus it is not surprising that developing brains in early childhood are more susceptible to metabolic insult, particularly those resulting from perturbations in blood glucose levels. Type 1 diabetes (T1DM) is one of the most common chronic diseases of childhood and the condition most likely to cause the greatest fluctuations in blood glucose. Studies from RCH/MCRI have led the way in our understanding of the impacts of T1DM upon brain ontogeny. Nearly 20 years ago Assoc Prof Liz Northam commenced the prospective RCH Diabetes Cohort Study to investigate the impacts of T1DM upon brain development cognition and mental health. A rather lamentable rule of thirds was the discovery. From diagnosis to the time of neuro-maturity in children with T1DM: there was a loss of 0.3SD in full scale IQ, one third developed a DSM-IV mental health disorder, one third did not complete secondary school and one third fell out of adult care after transition. These findings have led to a subsequent series of ongoing mechanistic and interventional studies using basic science and clinical techniques ranging from cell culture to insulin pump therapy and glucose clamp/functional MRI studies. The goal of the MCRI Diabetes Research Group is to derive a neuro-protective therapy that is independent of blood glucose control to facilitate optimal brain development in children with T1DM.
SPEAKER
Professor Fergus Cameron is the Head of Diabetes Research Group at the Murdoch Childrens Research Institute and a consultant endocrinologist at The Royal Children’s Hospital Melbourne. He has published widely in the medical and lay literature about matters regarding endocrine and diabetes management. His particular interests are the impacts of type 1 diabetes upon central nervous system development and psychosocial aspects of care. He is a past council member of the International Society for Paediatric and Adolescent Diabetes and is a participant in the Hvidoere Study Group on Childhood Diabetes. He is a current president of the Australasian Paediatric Endocrine Group.
Dr Michele O’Connell is a consultant endocrinologist at the Royal Children’s Hospital Melbourne and a member of the Diabetes Research Group at Murdoch Childrens Research Institute. Her principle area of clinical and research interest is Type 1 Diabetes. While Michele’s early research was largely in the field of diabetes-related technologies, her work in in recent years has focused on improving our understanding of, and ameliorating the effects of diabetes on the brain. The work Michele will present today relates to a recent study carried out at the Melbourne Children’s campus on the acute effects of both hypoglycaemia and hyperglycaemia on brain function in adolescents with Type 1 diabetes – the first study of its kind in a paediatric cohort.