ABSTRACT NUMBER: ESOC2026A790 MODERN APPROACHES TO THE EARLY DIAGNOSIS OF CEREBRAL DISORDERS IN CHILDREN AND ADOLESCENTS WITH DIABETES MELLITUS

Abstract Background and aims Diabetes mellitus (DM) is considered one of the most pressing global public health problems, as it is associated with numerous complications affecting various organs and systems [1]. In type 1 diabetes mellitus (T1DM), the brain is particularly vulnerable, with cognitive and emotional domains being most commonly affected [2]. Therefore, early diagnosis of these disturbances may reduce the risk of future disability in children and improve their quality of life. Methods The study included 78 children diagnosed with T1DM aged 7–18 years, with a disease duration of no more than 3 years. Results Neuropsychological testing revealed moderate cognitive impairment as well as moderate levels of both state and trait anxiety. Proton magnetic resonance spectroscopy (¹H-MRS) demonstrated that the most pronounced metabolic changes were localized in brain regions responsible for cognitive and emotional processing, including the hippocampus, subcortical structures, and the thalamus. A decrease in the N-acetylaspartate to creatine ratio (NAA/Cr) was observed, indicating energy imbalance and early disruption of neuronal integrity and connectivity. In addition, an increase in the choline to creatine ratio (Cho/Cr) was detected, reflecting cellular energy depletion in the affected brain regions. A notable degree of correlation was established between ¹H-MRS findings and MoCA test scores, as well as between ¹H-MRS results and anxiety assessment outcomes. Conclusions The use of ¹H-MRS for the early diagnosis of cognitive and emotional disturbances in children with diabetes mellitus is justified, as it enables visualization of brain metabolic abnormalities associated with cerebral dysfunction already at the preclinical stage.