NPPB and diabetes mellitus: NT-proBNP has been associated with worse cognition and incident dementia, and it has been suggested that this may operate through a role in regulating the blood-brain barrier, neurotransmission, and neuroinflammation.43,44 Paradoxically, there is evidence that elevated NT-proBNP is associated with reduced risk of type 2 diabetes mellitus,45 which should be beneficial in terms of neurological damage.