Effect of Hypoglycemia on Brain Structure in People With Type 2 Diabetes: Epidemiological Analysis of the ACCORD-MIND MRI Trial |
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| Authors: | Zi Zhang James Lovato Harsha Battapady Christos Davatzikos Hertzel C Gerstein Faramarz Ismail-Beigi Lenore J Launer Anne Murray Zubin Punthakee Amilcar A Tirado Jeff Williamson R Nick Bryan Michael E Miller |
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| Institution: | 1University of Pennsylvania, Philadelphia, PA;2Wake Forest University, Winston Salem, NC;3McMaster University, Hamilton, Ontario, Canada;4Case Western Reserve University, Cleveland, OH;5National Institute on Aging, Bethesda, MD;6Hennepin County Medical Center, Minneapolis, MN;7Columbia University, New York, NY |
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| Abstract: | OBJECTIVEThe effect of hypoglycemia related to treatment of type 2 diabetes mellitus (T2DM) on brain structure remains unclear. We aimed to assess whether symptomatic severe hypoglycemia is associated with brain atrophy and/or white matter abnormalities.RESULTSOf the 503 T2DM participants (mean age, 62 years) with successful baseline and 40-month brain MRI, 28 had at least one HA episode during the 40-month follow-up. Compared with participants without HA, those with HA had marginally significant less atrophy (less decrease in TBV) from baseline to 40 months (−9.55 95% CI −15.21, −3.90] vs. −15.38 95% CI −16.64, −14.12], P = 0.051), and no significant increase of AWM volume (2.06 95% CI 1.71, 2.49] vs. 1.84 95% CI 1.76, 1.91], P = 0.247). In addition, no unexpected local signal changes or volume loss were seen on hypoglycemic participants’ brain MRI scans.CONCLUSIONSOur study suggests that hypoglycemia related to T2DM treatment may not accentuate brain pathology, specifically brain atrophy or white matter abnormalities. |
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