Application of diffusion tensor imaging analysis along perivascular spaces in evaluating glymphatic system function in type 2 diabetes mellitus.

While the right-sided difference did not reach statistical significance, both mean and left-sided DTI-ALPS index showed significant reductions in the HOMA-IR group ( Table 3 ). 3.4 Comparative analysis of DTI-ALPS index across different stages of T2DM Patients with shorter disease duration demonstrated consistently higher DTI-ALPS index across all measures: mean (1.591 ± 0.302 vs. 1.380 ± 0.186, p = 0.014), left-sided (1.623 ± 0.299 vs. 1.367 ± 0.184, p = 0.003), and right-sided values (1.558 ± 0.441 vs. 1.392 ± 0.251) ( Table 4 ).

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