NEFL and diabetes mellitus: Specifically, NfL is a marker of neuronal damage,35 and axonal damage has been, in part, attributed to cerebral injuries, including cerebral vascular pathology.36 Cardiovascular health comprises vascular risk factors, such as hypertension and diabetes, known to contribute to vascular damage37 and, consequently, compromise blood-brain barrier integrity, thereby increasing neuronal damage and elevating NfL levels.