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Meta-analyses on gray and white matter changes in T2DM patients with cognitive impairment have concluded that T2DM impairs cognitive function by affecting specific brain structures ( The relationship between diabetes and cognitive impairment involves many aspects, including central insulin signal transduction, nerve fiber damage caused by hyperglycemia, neuritis, oxidative stress, blood–brain barrier damage, vascular neuropathy, changes in the dopaminergic system, and the effects of advanced glycation end products on metabolism and energy (Figure 1)