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Type 2 diabetes appears linked to brain degeneration
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Severity and duration of type 2 diabetes could contribute to brain degeneration, but not small vessel ischemic disease, according to research published in Radiology.
Patients from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study at the University of Minnesota, Wake Forest Medical School, Columbia University and Case Western Reserve University were invited to participate in the Memory in Diabetes substudy. Researchers looked at data from 614 patients (mean age, 62 years) to examine the association between type 2 diabetes and brain structure.
“As diabetes becomes more common, better understanding of the disease and its management becomes even more important in order to minimize its effect on patient health,” R. Nick Bryan, MD, PhD, professor of radiology at the Perelman School of Medicine at the University of Pennsylvania, said in a press release.
R. Nick Bryan
Bryan and colleagues evaluated baseline severity of diabetes in patients by testing fasting plasma glucose levels, HbA1c levels and duration of the condition (mean, 9.9 years). Through MRI with fluid-attenuated inversion recovery, proton-density, T2-weighted and T1-weighted sequences, post-processed with an automated computer algorithm, researchers classified brain tissue as gray or white matter and as normal or ischemic. Linear regression models were used to determine the relationship between diabetes measure and MRI outcomes.
Longer duration of diabetes and higher FPG levels were associated with lower normal (beta level=–0.431 and –0.053, respectively; P<.01) and total gray matter volumes (beta level=–0.428 and –0.053, respectively; P<.01). An inverse correlation was seen between FPG and ischemic lesion volume (beta level=–0.006; P<.04). HbA1c was not associated with any MRI measure.
“Our results suggested that, for every 10 years of diabetes duration, the brain of a patient with diabetes looks approximately 2 years older than that of a non-diabetic person, in terms of gray matter volume.” Bryan said. “They did not seem to have more vascular disease due to the direct effect of diabetes.”
These findings could have implications for decline of cognitive function in patients with diabetes, the researchers wrote, raising the possibility that cognitive changes are more related to neurodegenerative disorders such as Alzheimer’s disease than vascular dementia.
Disclosure: The study is from the Action to Control Cardiovascular Risk in Diabetes project, funded through an interagency agreement between the National Institute on Aging and the National Heart, Lung, and Blood Institute.
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