, Volume 51, Issue 8, pp 1556-1557
Date: 10 Jun 2008

Integrity of cerebral white matter in type 1 diabetes. Reply to Wessels AM [letter]

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To the Editor: We appreciate the valuable comments of Dr Wessels [1] on our recent article in Diabetologia [2]. We specifically sought to study the impact of white matter hyperintensities (WMHs) on brain structure in relatively young patients (age 32 ± 4 years) with diabetes of long duration (20 ± 4 years) (mean±SD). As Wessels noted, our large sample of patients did not differ from non-diabetic controls in terms of severity of white matter lesions. Indeed, our results are similar to those of Brands et al. [3], who studied cognition and WMHs in older type 1 diabetic adults with disease of longer duration associated with more complications. Taken together, these studies suggest that the incidence of WMHs in type 1 diabetes is not likely to be high. Using voxel-based morphometry, we have also found that, compared with non-diabetic controls, patients with type 1 diabetes had lower grey matter density and this was associated with both higher HbA1c levels and an increased number of severe h ...