Young adults with type 1 diabetes mellitus may develop subtle brain structural changes despite good clinical control and absence of overt complications, according to a case-control imaging study published in Diabetes Metabolism Research and Reviews. The findings suggest that long-standing type 1 diabetes may affect brain regions involved in executive function and working memory early in adult life.

The study enrolled 41 right-handed adults aged 18 to 30 years with clinically well-controlled type 1 diabetes of at least 10 years duration and 41 healthy controls matched for age, sex, intelligence quotient, and years of schooling. All participants underwent 3-T magnetic resonance imaging (MRI) with 1 mm³ voxel resolution. Imaging data were used to assess cortical gray matter, white matter, cortical thickness, and structural network relationships using graph-theoretical analyses.

Global cortical volumes were similar between groups. However, subcortical gray matter volume was lower in the diabetes group than in controls (43.4 cm³ vs 45.0 cm³; t[80] = −2.04; p=0.045; d=0.45). Reduced volumes were also reported in cerebellar white matter, vermis, brainstem, and several frontal and subcortical regions, including the putamen and thalamus. Longer diabetes duration and age at disease onset showed meaningful correlations with these changes. Structural network analyses also identified altered brain topology in the diabetes group.

These results indicate that mild alterations in brain morphology and organization may occur early in otherwise uncomplicated type 1 diabetes, potentially reflecting the disease’s influence on the developing brain.