Patients with type 2 diabetes have more pronounced brain atrophy and a higher likelihood of cerebral infarction, have suggested the results of a study published in the September issue of «Diabetes Care».

Dr. Jane S. Sazhinski (Jane S. Saczynski) (University of Massachusetts Medical School, Worcester) and colleagues investigated the association between glycemic status and pathological changes in the brain based on magnetic resonance imaging (MRI, MRI) in 4415 elderly residents of Iceland (average age 76 years) without dementia who participated in the «Age Gene / Environment Susceptibility-Reykjavik Study».

Overall, 2327 (53%) subjects had normoglycemia, 1599 (36%) - change of fasting glucose, and 489 (11%) patients - Type 2 diabetes.

After controlling for demographic and cardiovascular risk factors in patients with type 2 diabetes had significantly lower total brain volume (71.5% vs. 72.2%), gray matter (44.9% vs. 45.1%), and volume white matter (25.3% versus 25.7%) compared with subjects normo glycemic.

In patients with type 2 diabetes were also more likely single (OR 1.45) or multiple (odds ratio 2.27) of cerebral infarction, compared with normo glycemic patients.

Longer duration of diabetes was associated with a lower percentage of total brain volume, a lower percentage of the volume of gray and white matter, and a higher percentage of white matter lesions, as well as with significantly greater likelihood of having single or multiple cerebral infarcts.

Upon repeated analysis using antidiabetic drugs and the levels of hemoglobin A1C were assessed on the volume of brain tissue and the presence of cerebral infarcts. Only 56% of diabetic patients taking hypoglycemic agents or insulin.

Compared with diabetics who did not receive treatment, patients on treatment had a significantly lower percentage of total brain volume (adjusted mean percentage of 70.9 against 72.4) and a lower percentage of gray matter volume (44.5 vs. 45 and 4) and white matter (24.9 vs. 25.6), according to the report.

The authors found no association between A1C quartiles and the volume of brain tissue or the presence of heart attacks.

"These results are based on cross-sectional data and should be repeated in longitudinal studies" - the researchers note.

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