Whereas common complications of type-2 diabetes, including kidney disease, foot problems and vision problems, are generally well recognized, the disease's impact on the brain is often overlooked. Vera Novak, from Beth Israel Deaconess Medical Center (Massachusetts, USA), and colleagues studied 147 subjects (71 diabetic and 76 nondiabetic, average age 65 years), imaging the brain, measuring adhesion molecules and other markers of vascular health, and assessing cognitive parameters.  The team revealed that in older patients with diabetes, two adhesion molecules – sVCAM and sICAM – cause inflammation in the brain, triggering a series of events that affect blood vessels and, eventually, cause brain tissue to atrophy. Importantly, they found that the gray matter in the brain's frontal and temporal regions -- responsible for such critical functions as decision-making, language, verbal memory and complex tasks – is the area most affected by these events.   Observing that: “Diabetes is associated with cortical atrophy, vasoconstriction, and worse performance,” the study authors submit that: “Adhesion molecules, as markers of vascular health, have been indicated to contribute to altered vasoregulation and atrophy.”