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Will Type 2 Diabetes Shrink the Brain?

New research indicates that people with type 2 diabetes may lose more brain volume than expected as they age…. 

The researchers said that the shrinkage doesn’t appear to be linked to the damaging effect of diabetes on tiny blood vessels in the brain, but instead by how the brain handles excess sugar.

Lead researcher Dr. R. Nick Bryan, a professor of radiology at the University of Pennsylvania’s Perleman School of Medicine in Philadelphia, stated in a news conference that, "We have known for a long time that diabetes is not good for the brain."

Diabetes is associated with an increased risk for stroke and dementia, he said. Until now, doctors have thought these risks were likely related to blood vessel damage related to diabetes.

"But our study suggests that there is additional damage to the brain which may be more like a brain disorder such as Alzheimer’s disease," Bryan said. "So there may be two ways diabetes affects the brain, damage to blood vessels and brain-cell degeneration." Bryan cautioned, however, that what isn’t known from this study is whether treating diabetes will prevent or slow brain shrinkage.

For the study, they used MRI scans to look at the brains of 614 people with type 2 diabetes. The volunteers had had diabetes for an average of about 10 years. They found that the longer a patient had the disease, the more brain volume loss occurred, particularly in the gray matter. Gray matter includes areas of the brain involved in muscle control, seeing and hearing, memory, emotions, speech, decision-making and self-control.

They noticed that, for every 10 years someone had diabetes, the brain looked as if it was about two years older than the brain of someone without diabetes.

It’s important to note that this study only found an association between type 2 diabetes and greater and faster brain volume loss, and doesn’t prove a causal connection.

Practice Pearls:
  • Diabetes is associated with an increased risk for stroke and dementia.
  • The longer a patient had the disease, the more brain volume loss occurred, particularly in the gray matter.
  • Chronic high levels of insulin and sugar could be toxic to brain cells which could cause dementia.

R. Nick Bryan, M.D., Ph.D., professor, radiology, Perleman School of Medicine, University of Pennsylvania, Philadelphia; Sam Gandy, M.D., Ph.D., director, Center for Cognitive Health, Mount Sinai Hospital, New York City; Spyros Mezitis, M.D., endocrinologist, Lenox Hill Hospital, New York City; Souhel Najjar, M.D., director, Neuroscience and Stroke, Staten Island University Hospital, Staten Island, N.Y.; April 29, 2014, Radiology, online