Abstract
The continually increasing number of patients with type 2 diabetes is a worldwide health problem, and the incidence of microvascular complications is closely related to type 2 diabetes. Structural brain abnormalities are considered an important pathway through which type 2 diabetes causes brain diseases. In fact, there is considerable evidence that type 2 diabetes is associated with an increased risk of structural brain abnormalities such as lacunar infarcts (LIs), white matter hyperintensities (WMHs), and brain atrophy. WMHs are a common cerebral small-vessel disease in elderly adults, and it is characterized histologically by demyelination, loss of oligodendrocytes, and vacuolization as a result of small-vessel ischemia in the white matter. An increasing number of studies have found that diabetes is closely related to WMHs. However, the exact mechanism by which type 2 diabetes causes WMHs is not fully understood. This article reviews the mechanisms of type 2 diabetes-related WMHs to better understand the disease and provide help for better clinical treatment.
Highlights
With the increasing aging population in China, the incidence rate of type 2 diabetes among the elderly is increasing yearly
white matter hyperintensities (WMHs) are a silent brain injury that appears around the cerebral ventricles and/or deep subcortical white matter that are seen as high-intensity lesions in T2-weighted and fluid-attenuated inversion recovery (FLAIR) images and as isointense or hypointense on T1-weighted images on magnetic resonance imaging [1]
A recent review by Del Bene et al more firmly emphasized the relationship between type 2 diabetes and both the presence and severity of WMHs, the underlying mechanism is still not fully understood [6]
Summary
With the increasing aging population in China, the incidence rate of type 2 diabetes among the elderly is increasing yearly. In the present systematic review, we discuss the possible mechanisms for WMH-related type 2 diabetes to provide new ideas for the prevention and treatment of the condition.
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