ArticleCureus2025
Prospective Assessment of Alzheimer's Disease-Like Hypometabolism Pattern in the Brain of Diabetics in Contrast to Non-diabetics on Positron Emission Tomography-Computed Tomography Images Using Fluorodeoxyglucose in India.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDiabetes mellitus (DM) is a known risk factor for cognitive decline and Alzheimer's disease (AD), possibly due to insulin resistance and impaired cerebral glucose metabolism. Fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) imaging has shown AD-like hypometabolism patterns in diabetic individuals in various global studies. However, such data is lacking in the Indian population. This study investigated the presence of AD-like hypometabolism in Indian diabetic patients compared to non-diabetic controls. AIM AND
objectiveThis study aimed to evaluate whether the Indian diabetic patients show AD-like reduction in brain glucose metabolism, as several studies reported AD-like hypometabolism in the brain at very early stages before making a clinical diagnosis of probable AD. MATERIALS AND
methodsA prospective, observational study was conducted on 78 patients (39 diabetics and 39 non-diabetics; age range 43-87 years) at a tertiary care center. After excluding patients with a recent history of stroke, transient ischemic attack, or structural brain abnormalities, all participants underwent dedicated brain FDG PET-CT imaging just after a whole-body scan. Scans were analyzed using CORTEX-ID software (GE Healthcare, Chicago, IL, USA), comparing cerebral glucose metabolism to age-matched normative data. Regional hypometabolism was normalized to thalamic activity. Appropriate tests of significance were used, and P< 0.05 was considered statistically significant. Results: The study included 78 patients, 39 diabetics and 39 non-diabetic controls, matched for sex (19 males and 20 females in each group). Diabetic patients had a higher mean age (66.4 ± 10.6 years). The Mini-Mental State Examination (MMSE) score was lower in diabetics (25.3 ± 2.3) than in controls (26.8 ± 1.9). About 5.1% of diabetic patients showed an AD-like pattern, and the remaining 94.9% did not show an AD-like pattern on the FDG PET-CT scan. An AD-like pattern was not seen in any patient among the non-diabetic control group. No statistically significant association was found between the AD-like pattern in the brain on FDG PET-CT and diabetes (P
conclusionsNo significant incidence of "AD-like pattern" in the brain on PET-CT images using FDG was seen in this research study on the Indian diabetic populations. However, abnormal brain scans with no AD-like hypometabolism patterns possibly suggested other etiologies, likely depression. More prospective multicentric research studies on a large Indian diabetic population with age-matched non-diabetic control groups need to be explored for definite conclusions.
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