
This study investigated the longitudinal changes in brain volume and cognitive function associated with diabetes in mid‐life. In addition, this study also examined whether long‐term hyperglycemia, insulin resistance, or secretory function is associated with brain atrophy and cognitive decline. Type 2 diabetes was associated with more significant white matter volume reduction and executive function decline during the follow‐up period of 4.2 years. Long‐term hyperglycemia was a crucial independent factor associated with rapid cognitive decline in middle‐aged adults with diabetes. Maintaining ideal glucose levels in diabetes at mid‐life might prevent later rapid cognitive decline.
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