Abstract
AimsMetabolic disturbances may contribute to cognitive dysfunction in patients with type 2 diabetes. We investigated the relation between cognitive impairment and metabolic deteriorations, low physical fitness, low-grade inflammation and abdominal obesity in middle aged individuals.MethodsWe conducted a cross-sectional study including 40 to 65 year-old patients with type 2 diabetes and limited co morbidity (N = 56), age-matched individuals with impaired glucose tolerance (N = 56) as well as age-matched controls with normal glucose tolerance (N = 72). Specific cognitive functions were assessed with focus on verbal memory, processing speed, executive functions, and a composite overall mean score. Oral glucose tolerance test, VO2max test, systemic inflammation, DXA scanning and abdominal MRI were measured.ResultsMultiple linear regression analyses adjusting for age, gender and verbal intelligence demonstrated that a low score in processing speed, executive functions and overall cognitive function were related to high fasting C-peptide, as well as low insulin sensitivity, beta-cell function and VO2max. Measurements of blood glucose, obesity and inflammation were not associated with cognitive function.ConclusionLow cognitive scores are seen in middle aged individuals with hyperinsulinemia, low insulin sensitivity, beta-cell function and low aerobic capacity. These findings emphasize the importance of appropriate lifestyle and not only blood glucose control in prevention of cognitive disability.
Highlights
Diabetes is associated with increased risk of cognitive dysfunction in elderly people [1,2,3,4,5]
Patients with type 2 diabetes had higher HbA1c, fasting insulin, -C-peptide and -glucose compared to participants having Normal glucose tolerance (NGT)
The Matsuda composite index of insulin sensitivity were lower in participants having IGT and type 2 diabetes compared to NGT, whereas we found a compensatory higher beta-cell function (HOMA-B and insulinogenic index) in the individuals with impaired glucose tolerance compared to type 2 diabetes
Summary
Diabetes is associated with increased risk of cognitive dysfunction in elderly people [1,2,3,4,5]. In older individuals and in the severe states of type 2 diabetes, the presence of many confounding factors makes it difficult to determine the causative factors to cognitive disability. Previous transient cerebral ischemia (TCI), stroke, myocardial infarction, or atherosclerosis are all strong predictors of cognitive dysfunction [6]. Associations between high HbA1c and cognitive dysfunction have been demonstrated in elderly [2] and middle aged [7] individuals. In elderly patients with type 2 diabetes, acute deficits in working memory and attention were observed in the hyperglycemic state during a glucose clamp [8]
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