The Interactions of Disordered Eating Behavior, Glycemic Control, and Adiposity on Hypothalamic Gliosis in Adolescents and Young Adults with Type 1 Diabetes

One in five adolescents and young adults with type 1 diabetes (AYAD) exhibit disordered eating behaviors (DEB)—nearly twice the rate among healthy peers—associated with worse glycemic control, obesity, and higher risk of diabetes-related complications. The mechanisms that drive DEB are not well understood, limiting effective clinical treatment. The mediobasal hypothalamus (MBH) in the central nervous system is a key area of feeding regulation and MBH gliosis is associated with impaired satiety, hyperphagia and glucose dysregulation. It is unknown whether AYAD have hypothalamic gliosis related to DEB, insulin resistance and/or obesity, or if hyperglycemia independently drives the development of MBH gliosis, promoting changes in eating behavior and weight gain. Our study will apply complementary strategies to systematically uncover these complex interrelationships, including the use of non-invasive structural MRI on AYAD females, who have the highest rates of disordered eating behavior.