Cerebral small vessel disease (SVD) is more commonly observed in individuals with type 1 diabetes (T1D) compared with the general population, according to study results published in Diabetes Care.

T1D is associated with a dramatically higher risk for stroke and SVD is the most commonly observed etiology. However, data on cerebral SVD in this population is limited and difficult to study in vivo because of the size of the affected vessels. In this study, researchers evaluated the prevalence of cerebral SVD in 191 participants with T1D compared with 30 healthy controls. All study participants underwent clinical investigation and brain magnetic resonance imaging and were assessed for the presence of cerebral SVD.

Cerebral SVD was more common in individuals with T1D vs the control group. This was true for any type of marker (35% vs 10%; P =.005), cerebral microbleeds (24% vs 3.3%; P =.008), white matter hyperintensities (23% vs 6.7%; P =.051), and lacunes (2.1 vs 0%; P =1.0). Of the 67 patients with T1D and SVD, 32 (48%) had only cerebral microbleeds, 20 (30%) had only white matter hyperintensities, 11 (16%) had both cerebral microbleeds and white matter hyperintensities, 2 (3%) had both cerebral microbleeds and lacunes, and 2 (3%) had both white matter hyperintensities and lacunes. 

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Participants with cerebral microbleeds and T1D were more likely to have albuminuria (27 vs 12%; P =.021), be on antihypertensive medication (49% vs 32%; P =.033), and have higher systolic blood pressure (135 ± 17 mmHg vs 129 ± 13 mmHg; P =.009). However, only systolic blood pressure was independently associated with cerebral microbleeds (odds ratio, 1.03; 95% CI, 1.00-1.05; P =.035).

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The researchers stated that future studies will aim to examine the longitudinal development of SVD in T1D and its associations with brain health and cognition.

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Thorn LM, Shams S, Gordin D, et al. Clinical and MRI features of cerebral small-vessel disease in type 1 diabetes. Diabetes Care. 2018; dc181302.