Altered brain function and structure in youth-onset type 2 diabetes.

Objective: Despite the aggressive clinical trajectory of youth-onset type 2 diabetes (Y-T2D) and consistent evidence of cognitive dysfunction and poor brain health in adults with T2D, the impact of Y-T2D on brain function and structure is understudied.

Design: This study aimed to characterize brain function and structure in a cross-sectional sample of young people with Y-T2D and compare these brain attributes to peers with obesity alone (OB) or healthy weight (HW) without T2D.

Methods: Brain structure and function were measured via magnetic resonance imaging. Functional connectivity was estimated with a seed-to-voxel analysis and gray matter (GM) volume differences explored between groups.

Results: Forty young adult participants were included (Y-T2D: n = 12, mean [±SD] age 25.0 ± 7.2 years, diabetes duration 6.5 ± 6.7 years; OB: n = 8, age 19 ± 1.6 years; HW: n = 20, age 22.9 ± 4.1 years). The Y-T2D group showed stronger functional connectivity between the salience network and default mode network, compared to both the OB and HW groups (P < .05 for all, respectively). The Y-T2D group had reduced GM volume in regions associated with executive functioning, language, and visual processing relative to the OB and HW groups (P < .001 for all, respectively).

Conclusions: Y-T2D is associated with distinct alterations in brain function and structure, providing evidence of potentially compromised brain health in this clinical population.