Investigations of possible links between Alzheimer’s disease and type 2 diabetes mellitus by positron emission tomography: a systematic review

  • Reza Piri
  • Mohammad Naghavi-Behzad
  • Oke Gerke
  • Poul F. Høilund-Carlsen
  • Manouchehr Seyedi VafaeeEmail author
Systematic Review
Part of the following topical collections:
  1. Neuroimaging



To review published evidence of possible links between Alzheimer’s disease (AD) and type-2 diabetes mellitus revealed by positron emission tomography (PET).


We searched online databases with keywords diabetes mellitus (DM), AD, and PET. We assessed the studies in terms of purpose, methodology, materials, and relationships between AD and DM suggested by PET imaging.


After removal of 142 duplicates, 227 hits yielded no more than 15 full-length publications, from which we excluded six for specific reasons. The remaining nine studies were not directly comparable because of differences of purpose, study design, material, and methods. Individual subject materials consisted of 4–154 patients in case–control (4), observational (4), and longitudinal (1) studies, the last including only four DM patients. Mean patient age was 76.4 years (range 45–90). In five studies, researchers examined regional cerebral glucose metabolism with 18F-fluorodeoxyglucose (FDG), in three studies, researchers imaged amyloid with PET, and in one study, they measured both glucose metabolism and amyloid deposition. All four studies of amyloid tracers led to the conclusion that amyloid deposition was unaffected by DM status. Evidence of insulin resistance and increased blood glucose was associated with decreased FDG accumulation in AD signature regions in DM patients.


The relationships between DM and AD identified by PET appear to be independent of amyloid deposition and predominantly highlighted by reduced glucose metabolism, as suggested by four of the five glucose metabolism studies.


Alzheimer’s disease Diabetes mellitus Insulin resistance Positron emission tomography Dementia Systematic review 



We are grateful to Mrs. Herdis Foverskov (Library, Odense University Hospital, Odense, Denmark) for her assistance in the search process. This study was supported by the Lundbeckfonden Grant No. 124506.

Authors’ contribution

RP and MNB: content planning, literature search and review, writing, and editing. OG: literature search and editing. PFHC: content planning and editing. MSV: content planning, literature review, writing, and editing.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Human and animal rights

This article does not contain any studies with human or animal subjects performed by the any of the authors.

Supplementary material

40336_2019_339_MOESM1_ESM.docx (19 kb)
Supplementary material 1 (DOCX 19 kb)
40336_2019_339_MOESM2_ESM.doc (66 kb)
Supplementary material 2 (DOC 66 kb)


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Copyright information

© Italian Association of Nuclear Medicine and Molecular Imaging 2019

Authors and Affiliations

  • Reza Piri
    • 1
  • Mohammad Naghavi-Behzad
    • 1
    • 2
  • Oke Gerke
    • 1
  • Poul F. Høilund-Carlsen
    • 1
    • 3
  • Manouchehr Seyedi Vafaee
    • 1
    • 4
    • 5
    Email author
  1. 1.Department of Nuclear MedicineOdense University HospitalOdenseDenmark
  2. 2.Students’ Research CommitteeTabriz University of Medical SciencesTabrizIran
  3. 3.Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark
  4. 4.Department of PsychiatryOdense University HospitalOdenseDenmark
  5. 5.Department of Clinical Research, BRIDGE-Brain Research-Inter-Disciplinary Guided ExcellenceUniversity of Southern DenmarkOdenseDenmark

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