What can functional brain imaging teach us about remission of type 2 diabetes?

Diabet Med. 2023 Dec;40(12):e15235. doi: 10.1111/dme.15235. Epub 2023 Oct 20.

Abstract

Aims: With a paradigm shift in attitudes towards type 2 diabetes (T2D), 'weight loss responsive' diabetes is now thought of as a curable disease state. As a result, national programmes are being orchestrated to induce T2D remission soon after diagnosis with aggressive dietary interventions-such as very low-calorie diets (VLCD). However, dietary interventions to achieve weight loss and diabetes remission lack the same long-term sustainability and cardiovascular risk reduction evidence as bariatric surgery. This review aims to explore how brain imaging has contributed to our understanding of human eating behaviours and how neural correlates are affected by T2D.

Methods: We summarise functional MRI (fMRI) studies looking at human eating behaviour and obesity. We explore how these neural correlates are affected by insulin resistance and T2D itself as well as its different treatment approaches. Finally, we comment on the need for more personalised approaches to maintaining metabolic health and how fMRI studies may inform this.

Conclusion: fMRI studies have helped to fashion our understanding of the neurobiology of human appetite and obesity. Improving our understanding of the neural implications of T2D that promote disadvantageous eating behaviours will enable prevention of disease as well as mitigation against a vicious cycle of metabolic dysfunction and associated cognitive complications.

Keywords: fMRI; type 2 diabetes remission; weight loss.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bariatric Surgery*
  • Diabetes Mellitus, Type 2* / complications
  • Functional Neuroimaging
  • Humans
  • Obesity / complications
  • Obesity / surgery
  • Remission Induction
  • Treatment Outcome
  • Weight Loss