Diabetes Mellitus is a major lifestyle disease affecting millions of people around the world. The risk factors include obesity, stress, physical inactivity, familial causes, race and age. The patients may develop complications like nephropathy, neuropathy, cardiovascular disease, neurological disease, retinopathy, hearing impairment and cognitive impairment.
Many studies showed the decline in the different domains of the cognitive function in patients with bothtypes of Diabetes mellitus. In patients with type 1 diabetes, the domains mainly involved are general intelligence, psychomotor speed and mental flexibility. In type 2 diabetes, visual and verbal memory, executive functioning and information processing speed are involved.
Hyperglycemia, insulin resistance, vascular changes, amyloid deposit and hypoglycemia could be the possible reasons for the cognitive decline, The Cincinnati study focused on the gray matter volume in Type 2 diabetic teens. The study included 20 teens with type 2 diabetes. They matched the healthy controls and the diabetic group for age, sex and race. The diabetic group included teens between 10-20 years of age with HbA1c>7.9%, BMI>85% and with no previous neurological or psychiatric problems. The control group included lean subjects.
High resolution T1 weighted structural MRI was used to obtain the brain images for the study. Tissue segmentation analysis was used to calculate the total gray matter volume and total white matter volume. Voxel Based Morphometry was used to see the regional volume difference in the brain.
The results showed a significantly decreased total gray matter volume in the diabetic group. The total white matter volume and total brain volume showed no significant difference between the two groups. The adjusted gray matter volume i.e., the ratio between the total gray matter volume and total brain volume was found to be significantly less in the diabetic group. The adjusted white matter volume was not significantly different between two groups. The regional gray matter differences were found.
There was a decrease in total gray matter volume in six regions of the brain responsible for sight, hearing, speech, decision-making, self-control and memory. Prevention of diabetes by controlling the modifiable risk factors is necessary. But in patients with diabetes, glycemic control is essential to prevent hyperglycemia-related complications.