Søren N F Hostrup, Suganthiya S Croosu, Johan Røikjer, Carsten D Mørch, Christina Brock, Asbjørn M Drewes, Birgitte Brock, Janusiya A Muthulingam, Tine M Hansen, Niels Ejskjaer, Jens B Frøkjær
Accelerated brain aging has been reported in diabetes, but its links with diabetic peripheral neuropathy (DPN) and neuropathic pain remain unclear. We explored brain age gap (BAG) in type 1 diabetes to determine if it differs across neuropathic phenotypes, relates to clinical characteristics including DPN measures, and shows distinct regional patterns. Diabetes participants had 3.5 years of BAG, rising to 6-7 years in those with DPN. Diabetes duration was the main driver of BAG, whereas DPN had limited impact and neuropathic pain no clear contribution. BAG was widespread across the brain. Accelerated brain aging appears to affect people with diabetes regardless of neuropathic complications.