Correlative Analysis Of Blood Glucose Fluctuation And Brain Function In Type 2 Diabetic Patients

Objective To monitor the spontaneous changes of brain activity in patients with type 2 diabetes mellitus by using BOLD-f MRI,a new blood oxygenation-dependent magnetic resonance imaging technique.Methods Forty-two patients with type 2 diabetes mellitus(T2DM group)who underwent endocrine department from August 2015 to September 2016 were enrolled in this study.Twenty-eight healthy volunteers(control group)with similar age and sex composition were selected.First of all,the use of Medtronic dynamic blood glucose monitoring system for the admission of diabetic patients for 72 hours of continuous blood glucose monitoring.T2DM group was divided into two groups according to MAGE,MAGE>3.9mmol/L(group T2DML,n=28)and MAGE<3.9mmol/L(group T2DMs,n=14).For all subjects,brain function MRI was performed and ALFF signals were collected from all subjects and compared between the two groups.All subjects are generally collected clinical information such as: gender,age,systolic blood pressure(SBP),diastolic blood pressure(DBP),body mass index(BMI),duration of diabetes(CD),fasting plasma glucose(FPG),glycosylated hemoglobin(Hb Alc),blood lipids and so on.Monitoring of blood glucose fluctuations in the main reference indicator is MAGE.An independent sample t test was used between the two groups,and the ANOVA analysis was used in the three groups.Person correlation analysis was performed by the correlation analysis.Consequence1.One-way ANOVA analysis results between the three groups,there are differences between the three groups of brain areas are as follows: Pons,Cerebelum,Temporal_Pole such as Superior Temporal Gyrus,Temporal_Mid_R,Inferior Temporal Gyrus.Frontal Lobe such as Middle Frontal Gyrus,Superior Frontal Gyrus,Inferior Frontal Gyrus.Occipital Lobe such as Fusiform Gyrus.Limbic Lobe such as Cingulum_Ant,Precuneus,Parietal Lobe etc.(P < 0.001,there is statistical significance)2.Two independent sample t-test between diabetes group and normal control group,compared with normal control group decreased brain regions are as follows: Pons,Temporal_Pole such as Superior Temporal Gyrus.Parietal Lobe such as Parietal inf L.Limbic Lobe such as Cingulum Ant.Frontal Lobe such as Middle Frontal Gyrus.(P < 0.001,there is statistical significance)3.Two independent sample t-test between T2DML and T2DMS,compared with T2DMS increased brain regions are as follows: Cerebelum such as Cerebellum Posterior Lobe,Cerebellum Anterior Lobe.Frontal Lobe such as Inferior Frontal Gyrus,Superior Frontal Gyrus.compared with T2DMS decreased brain regions are as follows: Pons,Temporal Pole such as Inferior Temporal Gyrus,Superior Temporal Gyrus,Middle Temporal Gyrus.Occipital Lobe such as Fusiform Gyrus.Limbic Lobe such as Cingulum_Ant,Precuneus etc.(P < 0.001,there is statistical significance)4.There was a significant correlation between the fluctuation of blood glucose and the ALFF value of Parietal_Inf_L and Cingulum_Ant_L(r=-0.467,r=-0.500,P<0.05);the higher incidence of depression in diabetic patients.Conclusions 1.Patients with type 2 diabetes had significant abnormalities in resting brain Consequence function compared with non-diabetic patients,and these changes were associated with the onset of depression in diabetic patients.2.Type 2 diabetes patients with resting abnormal brain function and blood glucose fluctuations are associated with blood sugar fluctuations,the more obvious the abnormal.3.Type 2 diabetes patients in the daily management in addition to control hyperglycemia,reduce the level of insulin resistance,but also reduce the rate of blood glucose fluctuations.