Altered Brain Dynamics in Patients With Type 1 Diabetes During Working Memory Processing

Diabetes. 2018 Jun;67(6):1140-1148. doi: 10.2337/db17-1382. Epub 2018 Mar 12.


It is now generally accepted that diabetes increases the risk for cognitive impairment, but the precise mechanisms are poorly understood. A critical problem in linking diabetes to cognitive impairment is that patients often have multiple comorbidities (e.g., obesity, hypertension) that have been independently linked to cognitive deficits. In the study reported here we focused on young adults with and without type 1 diabetes who were virtually free of such comorbidities. The two groups were matched on major health and demographic factors, and all participants completed a verbal working memory task during magnetoencephalographic brain imaging. We hypothesized that patients would have altered neural dynamics in verbal working memory processing and that these differences would directly relate to clinical disease measures. Accordingly, we found that patients had significantly stronger neural responses in the superior parietal cortices during memory encoding and significantly weaker activity in parietal-occipital regions during maintenance compared with control subjects. Moreover, disease duration and glycemic control were both significantly correlated with neural responses in various brain regions. In conclusion, young healthy adults with type 1 diabetes already have aberrant neural processing relative to their peers without diabetes, using compensatory responses to perform the task, and glucose management and duration may play a central role.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Asymptomatic Diseases*
  • Cognitive Dysfunction / complications
  • Cognitive Dysfunction / diagnostic imaging*
  • Cognitive Dysfunction / physiopathology
  • Comorbidity
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetes Mellitus, Type 1 / physiopathology
  • Diabetic Nephropathies / diagnostic imaging*
  • Diabetic Nephropathies / physiopathology
  • Diabetic Nephropathies / prevention & control
  • Disease Progression
  • Female
  • Functional Neuroimaging
  • Glycated Hemoglobin / analysis
  • Humans
  • Hyperglycemia / prevention & control
  • Hypoglycemia / prevention & control
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Magnetoencephalography
  • Male
  • Memory, Short-Term* / drug effects
  • Nebraska / epidemiology
  • Occipital Lobe / diagnostic imaging
  • Occipital Lobe / drug effects
  • Occipital Lobe / physiopathology
  • Parietal Lobe / diagnostic imaging
  • Parietal Lobe / drug effects
  • Parietal Lobe / physiopathology
  • Verbal Behavior / drug effects
  • Verbal Learning / drug effects
  • Young Adult


  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin
  • hemoglobin A1c protein, human