A study of 614 patients with type 2 diabetes shows that, on average, for every 10 years of having diabetes, the brain experiences a decrease in volume that is equivalent to having aged an extra 2 years.
The researchers, led by Prof Nick Bryan of the Perelman School of Medicine, University of Pennsylvania, monitored patients from the ACCORD-MIND study. The patients, which all had type 2 diabetes, had a mean average of 62 years of age. 80% of participants had hypertension and around a quarter (26%) had cardiovascular disease. Changes in brain volume were assessed by magnetic resonance imaging (MRI) scans.
The research team found that longer duration of diabetes was associated with decreased brain volume in comparison with established figures for people without diabetes. The results suggest that each 10 year difference in diabetes duration is associated with a loss in total grey matter volume of 4.28 cubic centimetres.
The results showed that higher fasting plasma glucose (FPG) levels were associated with lower volumes of grey matter. A 50 mg/dl (2.8 mmol/l) difference in FPG levels predicted a 2.65 cubic cm difference in total grey matter volume.
The researchers also reported that the results suggested that cognitive changes, as a result of type 2 diabetes, are more likely related to neurodegenerative damage, as occurs in Alzheimer’s disease than by a lack of blood flow to the brain, as in vascular dementia.
The study shows that, in the average person with type 2 diabetes, diabetes has an accelerating effect on shrinking the brain. The fact that lower fasting glucose levels were associated with reduced brain shrinkage indicates that following strict lifestyle changes could help to minimise loss of brain volume.

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