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Aims/hypothesesIt is now generally accepted that diabetes increases the risk for cognitive impairment, but the precise mechanisms are poorly understood. In recent years, resting-state functional magnetic resonance imaging (rs-fMRI) is increasingly used to investigate the neural basis of cognitive dysfunction in type 2 diabetes (T2D) patients. Alterations in brain functional connectivity may underlie diabetes-related cognitive dysfunction and brain damage. The aim of this study was to investigate the changes in default mode network (DMN) connectivity in different glucose metabolism status and diabetes duration.MethodsWe used a seed-based fMRI analysis to investigate positive and negative DMN connectivity in four groups (39 subjects with normal glucose metabolism [NGM], 23 subjects with impaired glucose metabolism [IGM; i.e., prediabetes], 59 T2D patients with a diabetes duration of <10 years, and 24 T2D patients with a diabetes duration of ≥10 years).ResultsNegative DMN connectivity increased and then regressed with deteriorating glucose metabolism status and extending diabetes duration. DMN connectivity showed a significant correlation with diabetes duration.Conclusion/interpretationThis study suggests that DMN connectivity may exhibit distinct patterns in different glucose metabolism status and diabetes duration, providing some potential neuroimaging evidence for early diagnosis and further understanding of the pathophysiological mechanisms of diabetic brain damage.