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The proposed mechanisms of diabetes-related NDs include cerebral insulin resistance (IR), vascular endothelial dysfunction, inflammation, bloodbrain barrier injury, white matter disease of vascular origin, demyelination and axonal loss, and peroxidative membrane injury.11 Among these mechanisms, brain IR may play a primary role, and it is worth noting that neurologic complications may already occur with prediabetes IR.12 Oxidative stress,13 mitochondrial dysfunction,14 and endoplasmic reticulum (ER) stress15 are all involved in NDs induced by brain IR