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Article History

Received: 23 April 2025

Accepted: 7 July 2025

First Online: 7 October 2025

Acknowledgements

: The authors sincerely thank the adolescents who participated in this study and their families. We also acknowledge T. Jones and N. Paramalingam (Telethon Kids Institute, Perth, Western Australia) for their assistance and shared expertise in the conduct of hyperinsulinaemic clamp studies, as well as the technical assistance of M. Kean and the research MRI and neurodevelopmental imaging teams at Murdoch Children’s Research Institute Melbourne.

: Datasets generated from this study are available from the corresponding author on reasonable request.

: Open Access funding enabled and organized by CAUL and its Member Institutions. This work was supported by a pilot and feasibility grant awarded by a network of collaborating clinical research organisations involved in T1D research (‘the T1DCRN’) that has sites across Australia funded by Breakthrough T1D and the Commonwealth of Australia through the Australian Research Council’s (‘ARC’) Special Research Initiative for Type 1 Juvenile Diabetes. The research was also supported by a Pfizer Australia Australasian Paediatric Endocrine Care (APEC) grant. This work was investigator-initiated and led. Funding sources had no role in study design or conduct, nor in the writing of this report.

: The authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work.

: EAN and FJC were responsible for the study concept. MAOC, EAN, MLS, RB and FJC contributed to the experimental protocol and study design. MAOC, BM, EAN, MCF and FJC were responsible for participant recruitment and the conduct of the study. BM, EAN, MCF, RB and MLS collected and assembled data for analyses. RB and MLS designed the fMRI paradigm and analysed the fMRI data. MAOC drafted the manuscript, and all authors reviewed, edited and approved the final version of the manuscript. MAOC, RB and MLS are the guarantors of this work and, as such, have had full access to all data in the study and take responsibility for the integrity of the data and the accuracy of data analysis.