Progression of Cerebral Small Vessel Disease Among Neurologically Asymptomatic Middle-Aged Individuals With Type 1 Diabetes

Aleksi Tarkkonen; Iiris Kyläheiko; Jussi Inkeri; Marika I Eriksson; Lena M Thorn; Paula A Summanen; Turgut Tatlisumak; Per-Henrik Groop; Jukka Putaala; Daniel Gordin; Juha Martola; FinnDiane Study Group

doi:10.2337/dc24-1825

Progression of Cerebral Small Vessel Disease Among Neurologically Asymptomatic Middle-Aged Individuals With Type 1 Diabetes

Diabetes Care. 2025 Mar 17:dc241825. doi: 10.2337/dc24-1825. Online ahead of print.

Authors

Aleksi Tarkkonen^{1

2}, Iiris Kyläheiko^{2

3

4}, Jussi Inkeri^{1

2}, Marika I Eriksson^{5

6

7}, Lena M Thorn^{5

6

7

8}, Paula A Summanen^{5

7

9}, Turgut Tatlisumak^{10

11}, Per-Henrik Groop^{5

6

7

12

13}, Jukka Putaala¹⁴, Daniel Gordin^{2

6

15}, Juha Martola¹; FinnDiane Study Group

Affiliations

¹ Department of Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
² Minerva Foundation Institute for Medical Research, Helsinki, Finland.
³ Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland.
⁴ Department of Neurology, Kymenlaakso Central Hospital, Kotka, Finland.
⁵ Folkhälsan Research Center, Helsinki, Finland.
⁶ Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
⁷ Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
⁸ Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
⁹ Department of Ophthalmology, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.
¹⁰ Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
¹¹ Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden.
¹² Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia.
¹³ Baker Heart & Diabetes Institute, Melbourne, VIC, Australia.
¹⁴ Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
¹⁵ Joslin Diabetes Center, Harvard Medical School, Boston, MA.

PMID: 40095501
DOI: 10.2337/dc24-1825

Abstract

Objective: To investigate the potential progression rate of cerebral small vessel disease (CSVD) in brain MRI among neurologically asymptomatic middle-aged individuals with type 1 diabetes.

Research design and methods: A total of 172 individuals with type 1 diabetes were re-examined with brain MRI 7.5 years after their initial visit. Baseline predictors of changes in CSVD, particularly cerebral microbleeds (CMBs) and white matter hyperintensities (WMHs) were analyzed.

Results: The proportion of individuals with type 1 diabetes with CSVD increased from 36% to 70% (P < 0.001), CMBs increased from 17% to 33% (P < 0.001), and WMHs from 23% to 63% (P < 0.001) at follow-up. The increase in CMBs was associated with baseline systolic blood pressure, HbA1c, and preexisting CMBs. The increases in CSVD and WMHs were associated only with age.

Conclusions: The prevalence of CSVD doubled over a 7.5-year period in middle-aged individuals with type 1 diabetes.

Abstract

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