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A group of 22 patients with type 2 diabetes underwent MR spectroscopy of the deep gray matter nuclei and their metabolite ratios of NAA/Cr and Cho/Cr were assessed and correlated with laboratory findings. Metabolite ratios were different in the left and right lenticular nuclei and in the thalami, suggesting that diabetes affects these differently with the former being more vulnerable than the latter. The metabolic abnormalities preceded anatomic lesions.