Cognitive Performance in Adolescents with Type 2 Diabetes and Those Without: Pilot Data from a Case-Control Study

Abstract

Adolescent type 2 diabetes (T2D) diagnoses are on the rise. Consistent with the adult literature, preliminary evidence in adolescents suggests that T2D is associated with reduced brain volume and white matter microstructural integrity. As part of the Cognitive Performance in Adolescents with T2D (CPAT2D) study, this project aimed to test whether T2D diagnosis is associated with poorer cognitive performance in adolescents. Five adolescents with obesity and T2D (60% female; body mass index [BMI] percentile 98.2 ± 2.0; age 16.7 ± 1.1 years) were recruited and matched to two control adolescents with obesity but without T2D (50% female; BMI percentile 99.9 ± 0.2; age 15.9 ± 1.3 years) on at least three of the following characteristics: age, sex, pubertal stage and habitual sleep duration. All participants wore a wrist actigraphy device for seven consecutive nights to measure sleep at home and then completed two neuromotor cognitive tasks at a laboratory testing session assessing motor preparation (simple reaction time task) and executive functioning (affective shifting task [AST]). Control data were available through the Sleep Manipulation in Adolescents at Risk of Type 2 Diabetes (SMART2D) study. Premotor reaction time outcomes in either task and proportions of commission and omission error trials in the AST were subsequently analyzed. Based on this preliminary participant sample, there is no evidence to suggest that adolescents with compared to without T2D perform differently on the neuromotor cognitive tasks. The results should be confirmed once the intended sample size is reached. In the meantime, clinicians should monitor for changes in cognitive function in adolescents with T2D, perhaps by asking about academic achievement. The majority of our sample exhibited sub-optimal movement behaviours; to preserve overall health, adolescents with obesity and/or T2D should strive to meet sleep, physical activity and screen time recommendations for their age group.