The NewT Study at Washington University

Funding: Hershey, PI;  (DK064832) 2016-2021
HRPO #201601135

Clinical Trials # (https://clinicaltrials.gov/)

The Hershey Lab and collaborators are studying how the brain is a target organ in diabetes. In particular, we are interested in how brain development and exposure to hyperglycemia and hypoglycemia interact to shape developmental trajectories of the brain and its functions. This work has led to an understanding of the regional brain vulnerability in diabetes and has been funded for the past 10 years by the NIH (NIDDK). Collaborators on this work include: Neil White, MD, Ana Maria Arbelaez, MD, Kevin Black, MD, and Josh Shimony, MD.

The purpose of the NewT research study is to determine how symptoms at the time of Type 1 Diabetes Mellitus (T1DM) diagnosis, such as hyperglycemia and diabetic ketoacidosis (DKA) interact with age of onset to shape the development of the brain.

During both research visits (3 and 21 months post diagnosis) at WU and St. Louis Children’s Hospital, study participants will have a Mixed Meal Tolerance Test, complete a few thinking and memory tasks and undergo magnetic resonance imaging (MRI) of the brain. In addition, parents and participants are asked to fill out brief questionnaires. Data collected during each portion of the study visit are critical in helping us understand the neurological issues associated with Type 1 Diabetes and the brain.

Individuals diagnosed with T1DM in the past three months and their non-diabetic siblings between the ages of 4-16 years are needed for this research study.

For more information or if you (your child/children) are interested in participating in the NewT Study please contact Samantha Ranck, MSW, MA, PLPC at 314-362-6514 or blankens@wustl.edu. You will be asked to complete a phone screen to determine your child’s eligibility.

To view, download or print the Informed Consent Document for the NewT study, please click on below link:            

Pediatric Ambulatory Research in Cognition (PARC) Study

Management of blood glucose with type 1 diabetes (T1D) is challenging for youth and often results in frequent swings between normal, high, and low glucose (Awoniyi, 2013) like that shown in Figure 1. This glucose variability remains poorly understood, but research has shown that it is a potential risk factor for diabetic complications (Ceriello, 2019). One of the least understood complications of T1D is cognitive impairment. Several studies have shown impaired cognitive function in youth with T1D compared to their non-diabetic peers, and that poorer glycemic control including severe glycemic events (e.g., severe hypoglycemia) and chronic hyperglycemia are associated with cognitive impairments (Cato 2016). These studies assessed the important relationship between long-term glucose variability in T1D and cognition; however, little is still known about how cognitive function is impacted daily in real-life settings, particularly with dynamic cognitive skills that fluctuate throughout the day (e.g., working memory) (Gamaldo, 2016).

The goal of the PARC study is to evaluate real-time, real-life dynamic cognitive function variability in youth with T1D using a unique combination of novel, continuous health methods (i.e., continuous glucose monitoring), cognitive data collection methods (i.e., smartphone application), and machine learning models. Understanding how these dynamic cognitive skills are affected in daily life could be an important first step in establishing crucial improvements in academic accommodations and treatment recommendations for youth with T1D.

Figure 1. An example of typical daily glucose fluctuations from continuous glucose monitoring in a patient with T1D in good control (HbA1c=5.3%)