Brain microstructural alterations in type 2 diabetes: diffusion kurtosis imaging provides added value to diffusion tensor imaging.

• Diffusion kurtosis imaging detects more brain regions with microstructural alterations in white matter and gray matter of T2DM patients than DTI. • Mean kurtosis changes are associated with disease severity and impaired neuropsychological function in T2DM. • Diffusion kurtosis imaging demonstrates potential to assess cognitive impairment in T2DM patients and predict disease progression.