The role of MRI in diagnosing, staging and treating diabetes.

Specialties Article 3 Minute Read GE Healthcare Global

Imaging doesn’t tend to be a primary go-to when making a basic diabetic diagnosis. The most common diagnostic tools for determining whether someone has diabetes include a medical history and examination along with blood screening in the form of an A1C test, fasting blood sugar test or oral glucose tolerance test.1 In each of these cases, clinicians want to see how the body handles sugar (glucose) and produces insulin.

But magnetic resonance imaging (MRI) can play a large role in care over the life of a person with diabetes. Some ways MRI is used when treating someone with diabetes include diagnosing or ruling out rare conditions and monitoring patients for certain complications or risks so the right treatment plan can be enacted.

MRI used to diagnose a rare condition

Diabetes insipidus is actually a very different condition from diabetes mellitus. The latter is the diagnosis that relates to the processing of sugars by the body. Diabetes insipidus is a much rarer disorder that causes the level of water in the body to skew out of balance. Individuals with this disorder experience extreme levels of unquenchable thirst and very large volumes of urine excretion.2

An MRI of the head is one of the ways doctors can diagnose this condition because abnormalities near the pituitary gland can be an indicator that you have diabetes insipidus.

MRI’s role in diagnosis and treatment of diabetic complications

For the more common diabetes mellitus, MRI performs a critical role in helping clinical teams treat complications of the disease. When imaging is used as part of a comprehensive treatment program for someone with diabetes mellitus, it may even help medical teams determine the risk of a complication before the patient is in danger. With a chronic disorder such as diabetes, being aware of early warning signs and acting proactively with treatment methods are some of the best ways to keep individuals as healthy as possible over the long term.

Here are just some of the ways MRI plays a role in monitoring and treating diabetic-related conditions.

  • Diagnosis diabetic cardiomyopathy (DCM). DCM impacts around 12 percent of people with diabetes and is a condition of the heart. When left unchecked, it can lead to heart failure and even death. Cardiac MRI helps clinicians diagnose this complication by providing information about a range of heart functions and parts, including the size of chambers and distribution of mass within the organ.3
  • Diabetic foot complications. A variety of factors leave those with diabetes prone to foot complications. Understanding what, exactly, is going on in the diabetic foot can help clinicians plan appropriate treatment and prevention to ensure long-term use of the limb and support mobility and ambulation. MRI has been shown to be a sensitive, accurate imaging tool for this purpose, with evidence from the noninvasive imaging correlating with surgical findings.4
  • Kidney failure. Studies indicate that MRI’s of the brain may help medical teams predict risks of kidney failure in diabetic patients. Risk prediction allows clinical teams to take steps to mitigate damage to the kidney and perhaps stave off failure to promote longer and higher quality life. Japanese researchers note that “silent strokes,” or activity in the brain that may otherwise go unnoticed, is seen on MRI and may be connected with a risk of kidney failure in patients who have type 2 diabetes. While the scans might not be cost-effective for routine exams at this time, the researchers point to a need for new strategies and the incorporation of imaging into the care of diabetic patients.5
  • Dementia and other brain disorders. Researchers have also delved into whether MRI can predict risk factors for stroke, dementia and other brain disorders for those with diabetes. While research continues to be conducted in this field, as scientists collect more data, the ability of MRI to scan the brain for lesions will likely play a continued and growing role in this area.6

Other areas where radiology (and MRI in particular) can be helpful in monitoring and planning for treatment of diabetic complications include diabetic nephropathy, diabetic retinopathy, vascular complications, atherosclerosis, infections and erectile dysfunction.7

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The takeaway for diabetic patients

Patients who have been diagnosed with diabetes can find peace of mind in the fact that medical researchers are constantly finding new ways to manage the disease and help prevent complications from occurring. They can also talk to their health care providers about the role of MRI in diagnosis and planning for treatment of any complications that do arise.

References

1. “Diabetes Diagnosis.” Mayo Clinic. Web. 24 November 2018. <https://www.mayoclinic.org/diseases-conditions/diabetes/diagnosis-treatment/drc-20371451>.

2. “Diabetes insipidus.” Mayo Clinic. Web. 24 November 2018. <https://www.mayoclinic.org/diseases-conditions/diabetes-insipidus/symptoms-causes/syc-20351269>.

3. A. Lorenzo-Almoros, et. al. “Diagnostic approaches for diabetic cardiomyopathy.” BMC Medicine: Cardiovasclar Diabetology. Web. 24 November 2018. <https://cardiab.biomedcentral.com/articles/10.1186/s12933-017-0506-x>.

4. Mayank Mahendra and Rahul Singh. “Diagnostic Accuracy and Surgical Utility of MRI in Complicated Diabetic Foot.” Journal of Clinical & Diagnostic Research. Web. 24 November 2018. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5583782/>.

5. John Gever. “MRI Reveals Risk for Kidney Failure in Diabetic Patients.” MedPage Today. Web. 24 November 2018. <https://www.medpagetoday.com/nephrology/diabetes/18195>.

6. Lenore Reinhold Schmidt, et. al. “Magnetic Resonance Imaging of the Brain in Diabetes.” American Diabetic Association. Web. 24 November 2018. <http://diabetes.diabetesjournals.org/content/53/3/687>.

7. Athanosios Raptis, et. al. “What the radiologist needs to know about the diabetic patient.” Insights into Imaging. Web. 24 November 2018. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3259362/>.