Endocrine Abstracts

Purpose of the study

Evaluation of cerebral microcirculation using contrast and non-contrast magnetic resonance perfusion in patients with type 1 diabetes and cognitive dysfunction.

Material and methods

The study complied with generally accepted ethical rules. The study included 45 patients with type 1 diabetes mellitus with cognitive dysfunction and 20 patients without. All patients were continuously monitored glycemia. Magnetic resonance imaging was performed on a Signa Creator ’E’ magnetic resonance imaging machine, GE Healthcare, 1.5 Tesla, China: the techniques were dynamic contrast (’Gadovist’, IV, bolus, 5 ml) and arterial spin labels.

Results

We found decreased blood flow velocity in patients with type 1 diabetes and cognitive dysfunction in the white and gray matter areas of the frontal, occipital and temporal lobes P ≤ 0.05). Hyperglycemia and the following glycemic variability indices - index of long-term glycemic increase, risk of hyperglycemia and hypoglycemia, rate of glycemic change, indicator of glycemic control quality - have the greatest effect on cortical structures according to perfusion data, and in case of uncontrasted glycemic control quality and rate of change, risks of hypo and hyperglycemia. The main factors of cerebral microcirculatory changes are history of severe hypoglycemia episodes, duration of disease, arterial hypertension and elevated cholesterol levels.

Conclusion

The level of glycated hemoglobin and glycemic variability, as well as acute complications, duration of DM, and associated conditions (arterial hypertension and hypercholesterolemia) underlie microcirculatory impairment of the brain in type 1 diabetes. The most significant data were obtained with contrast perfusion.