Clinical and MRI Features of Cerebral Small-Vessel Disease in Type 1 Diabetes

Abstract

OBJECTIVE To assess the prevalence of cerebral small-vessel disease (SVD) in subjects with type 1 diabetes compared with healthy control subjects and to characterize the diabetes-related factors associated with SVD. RESEARCH DESIGN AND METHODS This substudy was cross-sectional in design and included 191 participants with type 1 diabetes and median age 40.0 years (interquartile range 33.0–45.1) and 30 healthy age- and sex-matched control subjects. All participants underwent clinical investigation and brain MRIs, assessed for cerebral SVD. RESULTS Cerebral SVD was more common in participants with type 1 diabetes than in healthy control subjects: any marker 35 vs. 10% (P = 0.005), cerebral microbleeds (CMBs) 24 vs. 3.3% (P = 0.008), white matter hyperintensities 17 vs. 6.7% (P = 0.182), and lacunes 2.1 vs. 0% (P = 1.000). Presence of CMBs was independently associated with systolic blood pressure (odds ratio 1.03 [95% confidence interval 1.00–1.05], P = 0.035). CONCLUSIONS Cerebral SVD, CMBs in particular, is more common in young people with type 1 diabetes compared with healthy control subjects.