Cognitive dysfunction in diabetes is associated with glycemic control in an urban Indian population: A prevalence study

Abstract

We evaluated the correlation between HbA1C and Cognitive derangement of type 2 Diabetics in the current prevalence study.HbA1C as a Biomarker to predict Cognitive Derangement in Type 2 Diabetic Subjects based on the correlation findings in a prevalence study in urban Indian population. We further investigated the role of poor Diabetes control versus hypoglycemia episodes as independent predictors of cognitive derangement in 240 type 2 Diabetics.In pilot phase ,comparison between Diabetics(n=30)and non-Diabetic subjects(n=30)for Cognitive derangement using cognitive batteries: GPCOG, AI tool and MIS was done. PET CT brain findings of one of Diabetic subjects were also observed. Further study was conducted on 240 diabetic subjects using batteries validated in the pilot phase. Pilot study provided statistically significant results of correlation between HbA1C levels versus GPCOG Score, Pearson's Correlation r1= -0.448*, for AI Score Pearson’s Correlation r2= -0.196*and for MIS score Pearson’s Correlation r3= -0.472*. The prevalence ratio for both groups was calculated as 5.8125, which implies Diabetics had > 5 fold risk of deranged cognition as compared to the non-Diabetic group. Using independent T-test, mean GPCOG score in the Hypoglycemia group(n=162) and without hypoglycemia group(n=78) were found to be 3.02 and 4.63 respectively. Similarly, based on the independent T-test, the mean AI score in the Hypoglycemia group(n=162) and without hypoglycemia group(n=78) were found to be 2.068 and 2.564, respectively. PET CT brain findings were suggestive of reduced FDG uptake indicating Alzheimer’s type of cognitive derangement.HbA1C can be linked to poor cognitive derangement in case of poor diabetes control. Hence HbA1C can be a useful biomarker to predict cognitive derangement in type 2 Diabetics.*Significance level <0.01, Negative correlations are indicative of lower the values of battery scores higher would be cognitive derangement.