File Name: diabetes and cognitive impairment .zip
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Some patients with type 1 and type 2 diabetes mellitus DM present with cognitive dysfunctions. The pathophysiology underlying this complication is not well understood.
Metrics details. Diabetes is a risk factor for cognitive impairment, but whether there is also a link between pre-diabetes and cognitive dysfunction is not yet fully established. Regression analyses were performed to investigate associations between: a categories of normal or impaired glucose metabolism, and b OGTT measurements, respectively, as exposure variables and cognitive test results as outcomes. Adjustments were made for demographics, lifestyle factors and cardiovascular risk factors. Participants with pre-diabetes and diabetes scored slightly worse cognitive test results compared to the control group.
To investigate the risk factors for cognitive impairment in Chinese type 2 diabetes mellitus T2DM patients of advanced age and to identify effective biomarkers of mild cognitive impairment MCI in these patients. Chinese T2DM patients aged 50—70 years were divided into groups with impaired mild, moderate, and severe and normal cognitive function based on Montreal Cognitive Assessment and Mini-Mental State Examination scores. Data regarding demographic characteristics, clinical features of diabetes, biochemical markers, and metabolomics were collected. Age, educational level, duration of diabetes, fasting blood glucose FBG , HbA1c, total cholesterol TC , triglyceride TG , and hour urine protein were significantly associated with cognitive impairment in T2DM patients of advanced age. The severity of fundus retinopathy and the incidence of macrovascular disease also differed significantly among the groups. Metabolomics analysis suggested that increased levels of glutamate Glu , phenylalanine Phe , tyrosine Tyr , proline Pro , and homocysteine Hcy and a decreased level of glutamine Gln were significantly associated with cognitive impairment in the T2DM patients. Receiver operating characteristic curve analysis demonstrated that Glu, Gln, Phe, and Pro levels were significant predictors of cognitive impairment in the T2DM patients.
Relation of Diabetes to Mild Cognitive Impairment. Arch Neurol. Of participants with a complete neuropsychological evaluation, Diabetes was related to a significantly higher risk of all-cause MCI and amnestic MCI after adjustment for all covariates. Diabetes was also related to a higher risk of nonamnestic MCI, but this association was appreciably attenuated after adjustment for socioeconomic variables and vascular risk factors. The risk of MCI attributable to diabetes was 8.
Recent guidelines therefore recommend screening for cognitive impairment in older individuals with diabetes. In addition, these guidelines suggest that glucose-lowering treatment should be tailored in those diagnosed with cognitive impairment, to reduce the risk of hypoglycaemia and improve treatment adherence. This review gives an overview of cognitive dysfunction in people with diabetes, briefly describing the clinical features of different stages of cognitive dysfunction and their epidemiology. In particular, it addresses essential additional steps that need to be taken to fully implement the emerging guidelines on screening and management of cognitive dysfunction in diabetes into daily practice. Cognitive dysfunction is an important comorbidity of diabetes. This may reflect brain changes as a consequence of diabetes [ 1 ] but the co-occurrence of diabetes and cognitive dysfunction clearly also reflects shared risk factors, the most obvious of which is age.
There is strong evidence that diabetes mellitus increases the risk of cognitive impairment and dementia. Optimal glycemic control in type 1 diabetes and identification of diabetic risk factors and prophylactic approach in type 2 diabetes are very important in the prevention of cognitive complications. In addition, hypoglycemic attacks in children and elderly should be avoided. Anti-diabetic medications especially Insulin may have a role in the management of cognitive dysfunction and dementia but further investigation is needed to validate these findings. Core tip: Diabetes mellitus increases the risk of cognitive impairment and dementia.
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