Type 1 diabetes affects the structure and functioning of the brain, but the neurochemical mediators that may accompany these negative effects are largely unknown. We investigated brain metabolite levels with 1H MRS in patients with type 1 diabetes and normal awareness of hypoglycemia, patients with impaired awareness of hypoglycemia (IAH) and non-diabetic controls. Brain glutamate levels were elevated in type 1 diabetes and correlated with glycemic control and age of disease onset, but not with burden of hypoglycemia as reflected by IAH. This suggests a potential role for glutamate as early marker of hyperglycemia-induced cerebral decline in type 1 diabetes.
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