Association between brain imaging biomarkers and continuous glucose monitoring-derived glycemic control indices in Japanese patients with type 2 diabetes mellitus

Abstract

IntroductionAlthough type 2 diabetes mellitus (T2DM) is associated with alterations in brain structure, the relationship between glycemic control indices and brain imaging markers remains unclear. This study aimed to investigate the association between continuous glucose monitoring (CGM)-derived glycemic control indices and brain imaging biomarkers assessed by MRI.Research design and methodsThis cross-sectional study included 150 patients with T2DM. The severity of cerebral white matter lesions (WMLs) was assessed using MRI for deep and subcortical white matter and periventricular hyperintensities. The degree of medial temporal lobe atrophy (MTA) was assessed using voxel-based morphometry. Each participant wore a retrospective CGM for 14 consecutive days, and glycemic control indices, such as time in range (TIR) and glycemia risk index (GRI), were calculated.ResultsThe proportion of patients with severe WMLs showed a decreasing trend with increasing TIR (Pfor trend=0.006). The proportion of patients with severe WMLs showed an increasing trend with worsening GRI (Pfor trend=0.011). In contrast, no significant association was observed between the degree of MTA and CGM-derived glycemic control indices, including TIR (Pfor trend=0.325) and GRI (Pfor trend=0.447).ConclusionsThe findings of this study indicate that the severity of WMLs is associated with TIR and GRI, which are indices of the quality of glycemic control.Trial registration numberUMIN000032143.