Cognitive Performance In Type Research Articles

Metabolic-Associated Fatty Liver Disease and Cognitive Performance in Type 2 Diabetes: Basal Data from the Phytate, Neurodegeneration and Diabetes (PHYND) Study.

The effect of liver fibrosis on mild cognitive impairment (MCI) and dementia risk in type 2 diabetes mellitus (T2DM) patients is unclear. Therefore, we performed a prospective cross-sectional study on 219 patients with T2DM and older than 60 years to evaluate the association between liver fibrosis, liver steatosis, and cognitive impairment. The Montreal Cognitive Assessment (MoCA) was used to screen for MCI or dementia. Liver fibrosis was estimated using the non-invasive Fibrosis-4 (FIB-4) score, and liver steatosis was assessed with the hepatic steatosis index. The mean age was 71 ± 6 years, 47% were women and according to MoCA cut-off values, 53.88% had MCI and 16.43% had dementia. A moderate or high risk of advanced fibrosis was significantly higher in patients with MCI or dementia compared to those with normal cognition (p < 0.001). After adjusting for confounders, a FIB-4 score greater than 1.54 was associated with MCI or dementia (p = 0.039). Multivariate analysis identified age over 70.5 years, antiplatelet medication use, and a FIB-4 score above 1.54 as the most relevant risk factors. Liver fibrosis, but not liver steatosis, is associated with MCI or dementia in older T2DM patients, suggesting that FIB-4 score might be a simple biomarker for the detection of cognitive impairment.

White matter microstructure alterations in type 2 diabetes mellitus and its correlation with cerebral small vessel disease and cognitive performance

Microstructural abnormalities of white matter fiber tracts are considered as one of the etiology of diabetes-induced neurological disorders. We explored the cerebral white matter microstructure alteration accurately, and to analyze its correlation between cerebral small vessel disease (CSVD) burden and cognitive performance in type 2 diabetes mellitus (T2DM). The clinical-laboratory data, cognitive scores [including mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA), California verbal learning test (CVLT), and symbol digit modalities test (SDMT)], CSVD burden scores of the T2DM group (n = 34) and healthy control (HC) group (n = 21) were collected prospectively. Automatic fiber quantification (AFQ) was applied to generate bundle profiles along primary white matter fiber tracts. Diffusion tensor images (DTI) metrics and 100 nodes of white matter fiber tracts between groups were compared. Multiple regression analysis was used to analyze the relationship between DTI metrics and cognitive scores and CSVD burden scores. For fiber-wise and node-wise, DTI metrics in some commissural and association fibers were increased in T2DM. Some white matter fiber tracts DTI metrics were independent predictors of cognitive scores and CSVD burden scores. White matter fiber tracts damage in patients with T2DM may be characterized in specific location, especially commissural and association fibers. Aberrational specific white matter fiber tracts are associated with visuospatial function and CSVD burden.

BMI, insulin sensitivity, and cognition in early type 2 diabetes: The Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study.

This study exploredthe association of BMI and insulin sensitivity with cognitive performance in type 2 diabetes. A cross-sectional analysis of data from the baseline assessment of the Glycemia Reduction Approaches in Diabetes: a Comparative Effectiveness Study (GRADE) was conducted. BMI was used as a surrogate of adiposity and the Matsuda index as the measure of insulin sensitivity. Cognitive tests included the Spanish English Verbal Learning Test, the Digit Symbol Substitution Test, and the letter and animal fluency tests. Cognitive assessments were completed by 5018 (99.4%) of 5047 participants aged 56.7 ± 10.0 years, of whom 36.4% were female. Higher BMI and lower insulin sensitivity were related to better performance on memory and verbal fluency tests. In models including BMI and insulin sensitivity simultaneously, only higher BMI was related to better cognitive performance. In this study, higher BMI and lower insulin sensitivity in type 2 diabetes were cross-sectionally associated with better cognitive performance. However, only higher BMI was related to cognitive performance when both BMI and insulin sensitivity were considered simultaneously. The causality and mechanisms for this association need to be determined in future studies.

Cytochrome P450-soluble epoxide hydrolase derived linoleic acid oxylipins and cognitive performance in type 2 diabetes

Type 2 diabetes mellitus (T2DM) increases the risk of cognitive decline and dementia. Disruptions in the cytochrome P450-soluble epoxide hydrolase (CYP450-sEH) pathway have been reported in T2DM, obesity and cognitive impairment. We examine linoleic acid (LA)-derived CYP450-sEH oxylipins and cognition in T2DM and explore potential differences between obese and nonobese individuals. The study included 51 obese and 57 nonobese participants (mean age 63.0 ± 9.9, 49% women) with T2DM. Executive function was assessed using the Stroop Color-Word Interference Test, FAS-Verbal Fluency Test, Digit Symbol Substitution Test, and Trails Making Test-Part B. Verbal memory was assessed using the California Verbal Learning Test, second Edition. Four LA-derived oxylipins were analyzed by ultra-high-pressure–LC/MS, and the 12,13-dihydroxyoctadecamonoenoic acid (12,13-DiHOME) considered the main species of interest. Models controlled for age, sex, BMI, glycosylated hemoglobin A1c, diabetes duration, depression, hypertension, and education. The sEH-derived 12,13-DiHOME was associated with poorer executive function scores (F1,98 = 7.513, P = 0.007). The CYP450-derived 12(13)-epoxyoctadecamonoenoic acid (12(13)-EpOME) was associated with poorer executive function and verbal memory scores (F1,98 = 7.222, P = 0.008 and F1,98 = 4.621, P = 0.034, respectively). There were interactions between obesity and the 12,13-DiHOME/12(13)-EpOME ratio (F1,97 = 5.498, P = 0.021) and between obesity and 9(10)-epoxyoctadecamonoenoic acid (9(10)-EpOME) concentrations (F1,97 = 4.126, P = 0.045), predicting executive function such that relationships were stronger in obese individuals. These findings suggest that the CYP450-sEH pathway as a potential therapeutic target for cognitive decline in T2DM. For some markers, relationships may be obesity dependent.

Serum oxidized low density lipoprotein serves as a mediator for the inverse relationship between serum d-ribose and cognitive performance in type 2 diabetic patients

Chronic hyperglycemia, proinflammatory state, and oxidative stress are implicated in the etiology of mild cognitive impairment (MCI) in type 2 diabetes mellitus (T2DM) patients. However, roles and mechanisms of the diabetes-related dys-regulation of serum d-ribose in the pathogenesis remain unclear. This study was to assess: 1) changes of serum d-ribose in T2DM patients with or without MCI compared with healthy controls; and 2) associations of serum d-ribose with key biomarkers of ribosylation [advanced glycation end products (AGEs) and receptor for advanced glycation end products (RAGE)], inflammation (IL-6 and NF-κB) and oxidative stress [oxidized low density lipoproteins (ox-LDL), advanced oxidation protein products (AOPP), total thiol, and non-protein thiol)]. A cross-sectional study was conducted with 1564 initial participants including 362 T2DM patients. Based on their fasting blood glucose concentrations and Montreal cognitive assessment (MoCA) scores, we selected 89 participants and divided them into three groups: 27 healthy controls, 26 T2DM patients with normal cognition, 36 T2DM patients with MCI. All participants were gone through standard anthropometric tests and biochemical examinations of serum clinical profiles and concentrations of d-ribose, AGE, RAGE, IL-6, NF-κB, ox-LDL, AOPP, total thiol, and non-protein thiol. Serum concentrations of d-ribose, ox-LDL, and AOPP were greater (P < 0.05) in the T2DM-MCI patients than that in the T2DM or controls. Serum d-ribose exhibited a positive correlation (P < 0.05) with serum AGEs, RAGE, ox-LDL, and fasting blood glucose, but a negative correlation (P < 0.05) with MoCA score. This negative relationship remained (P < 0.05) after adjusting various covariates, and was found to be mediated (P < 0.05) by serum ox-LDL. In conclusion, our results reveal serum ox-LDL as a potential mediator for the inverse relationship between the elevation of serum d-ribose concentration and the decline of cognitive performance in the T2DM-MCI patients.

Effects of linagliptin vs glimepiride on cognitive performance in type 2 diabetes: results of the randomised double-blind, active-controlled CAROLINA-COGNITION study

Aims/hypothesisType 2 diabetes, particularly with concomitant CVD, is associated with an increased risk of cognitive impairment. We assessed the effect on accelerated cognitive decline (ACD) of the DPP-4 inhibitor linagliptin vs the sulfonylurea glimepiride in individuals with type 2 diabetes.MethodsThe CAROLINA-COGNITION study was part of the randomised, double-blind, active-controlled CAROLINA trial that evaluated the cardiovascular safety of linagliptin vs glimepiride in individuals with age ≥40 and ≤85 years and HbA1c 48–69 mmol/mol (6.5–8.5%) receiving standard care, excluding insulin therapy. Participants were randomised 1:1 using an interactive telephone- and web-based system and treatment assignment was determined by a computer-generated random sequence with stratification by center. The primary cognitive outcome was occurrence of ACD at end of follow-up, defined as a regression-based index score ≤16th percentile on either the Mini-Mental State Examination (MMSE) or a composite measure of attention and executive functioning, in participants with a baseline MMSE score ≥24. Prespecified additional analyses included effects on ACD at week 160, in subgroups (sex, age, race, ethnicity, depressive symptoms, cardiovascular risk, duration of type 2 diabetes, albuminuria), and absolute changes in cognitive performance. Participants, caregivers, and people involved in measurements, examinations or adjudication, were all masked to treatment assignment.ResultsOf 6033 participants recruited from hospital and primary care sites, 3163 (38.0% female, mean age/diabetes duration 64/7.6 years, MMSE score 28.5, HbA1c 54 mmol/mol [7.1%]) represent the CAROLINA-COGNITION cohort. Over median 6.1 years, ACD occurred in 27.8% (449/1618, linagliptin) vs 27.6% (426/1545, glimepiride), OR 1.01 (95% CI 0.86, 1.18). Also, no differences in ACD were observed at week 160 (OR 1.07 [0.91, 1.25]), between treatments across subgroups, or for absolute cognitive changes.Conclusions/interpretationIn a large, international outcome trial in people with relatively early type 2 diabetes at elevated cardiovascular risk, no difference in risk for ACD was observed between linagliptin and glimepiride over 6.1 years.FundingThis study was sponsored by Boehringer Ingelheim.Trial registrationClinicalTrials.gov NCT01243424.Graphical abstract

Long-term Change in Physiological Markers and Cognitive Performance in Type 2 Diabetes: The Look AHEAD Study.

The effects of physiological improvements on cognitive function among persons with type 2 diabetes mellitus (T2DM) are not fully understood. To determine whether improvements in physiological markers (body weight, blood sugar control, and physical activity) during intensive lifestyle intervention (ILI) are associated with enhancements in cognitive function in older adults with T2DM. Multisite randomized controlled trial. Academic research centers. Participants were aged 45-76 years, with T2DM. The Action for Health in Diabetes (Look AHEAD) study, a randomized, controlled clinical trial of ILI. Two to 3 cognitive assessments were collected from 1089 participants, the first and last occurring a mean (standard deviation) of 8.6 (1.0) and 11.5 (0.7) years after enrollment. Greater improvement in blood sugar control was associated with better cognitive scores (fasting glucose and Rey Auditory Verbal Learning Test [AVLT]: P = 0.0148; fasting glucose and Digit Symbol Coding (DSC): P = 0.0360; HbA1C and DSC: P = 0.0477); but weight loss had mixed associations with cognitive scores (greater body mass index [BMI] reduction and worse AVLT overall: P = 0.0053; and greater BMI reduction and better DSC scores among those overweight but not obese at baseline: P = 0.010). Associations were strongest among those who were overweight (not obese) at baseline, and among those with a history of cardiovascular disease (CVD) at baseline. Improvements in glycemic control, but not necessarily weight status, during ILI may be associated with better subsequent cognitive performance. These associations may differ by adiposity and CVD history.

Association between vascular measures and cognitive function in type 2 diabetes

AimTo examine correlation between vascular measures and cognitive performance in type 2 diabetes (T2D). MethodsThis was a cross-sectional study on patients (N = 1167) aged ≥45 years attending Diabetes Centre in a tertiary hospital and primary care polyclinic. The following vascular measures were measured: systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), pulse pressure (PP), pulse wave velocity (PWV) and augmentation index (AI). Cognition was assessed by Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Multiple linear regression was used to examine relationships between vascular measures and cognition, adjusting for demographics, education, depression, clinical covariates and presence of APOE Ɛ4 allele. ResultsIn unadjusted analyses, all the vascular measures, except for MAP, were associated with RBANS total score. In fully adjusted analyses, the association with RBANS total score persisted for peripheral PP, aortic PP and aortic DBP with βs −0.05 (95%CI -0.07 to −0.02; p = 0.001), −0.04 (95%CI −0.06 to −0.01; p = 0.002) and 0.05 (95%CI 0.00 to 0.09; p = 0.033). Association between peripheral and aortic PP and RBANS total score was unaffected by age-stratification (age <60 and ≥60 years). In contrast, significant association between aortic DBP and RBANS total score was only observed for those ≥60 years. Peripheral and aortic PP (which estimate pulsatility) are negatively associated with attention, visuospatial/constructional and language ability. ConclusionsPeripheral and aortic PP, and aortic DBP were independently correlated with cognitive performance globally and in multiple domains. Further research should be conducted to establish the clinical relevance and importance.

Correlation between BMI and cognitive performance in type 2 diabetic patients

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

The prevalence of sarcopenic obesity and its association with cognitive performance in type 2 diabetes in Singapore.

We aim to examine body composition, and association between SO and cognitive performance in Type 2 Diabetes (T2D) in an Asian population in Singapore. This was a cross-sectional study on 1235 patients with mean age 61.4±8.0 years and T2D primary and secondary care attending diabetes care in Singapore. Body composition was assessed using tetrapolar multi-frequency BIA device analysis. Fat mass to fat-free mass (FM/FFM) ratio was categorized into 3 groups: Group 1, normal, <0.40; Group 2, obese and increase of FM is small relative to that in FFM, 0.40 to 0.80; and Group 3, SO, >0.80. Cognition was assessed using Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Mini-Mental State Examination (MMSE). The distribution of body composition based on FM/FFM ratio was: Group 1, 20.2%; Group 2, 60.5%; and Group 3, 19.4%. SO (Group 3) was significantly associated with reduced RBANS total score with β-1.44 (95%CI -2.82 to-0.06; p=0.041) in multivariable linear regression adjusted for demographics, education, depressive symptom(s) and clinical covariates. SO was significantly associated with reduced index scores for immediate memory and language in fully adjusted models with corresponding βs-2.71 (95%CI -5.06 to-0.36; p=0.024) and-2.48 (95%CI -4.87 to-0.08; p=0.043). Association between SO and reduced MMSE score was similarly observed. The prevalence of SO in Asians with T2D is relatively high. There is consistent and independent association of SO with reduced cognitive performance, especially in domains of memory and language, which may impair complex executive function such as adherence to diabetes self-care management.

1601-P: Sarcopenic Obesity and Its Association with Reduced Cognitive Performance in Type 2 Diabetes in Singapore

Introduction: Little is known of association between sarcopenic obesity (SO) and cognition. We aim to examine body composition, and association between SO and cognitive performance in type 2 diabetes (T2D). Methods: This was a cross-sectional study on 1,317 patients with mean age 61.7±8.2 years and T2D attending both primary and secondary diabetes care in Singapore. Sarcopenia was defined using multi-frequency bio-impedence estimated appendicular skeletal muscle mass divided by height2 with cut-off for Asians (&amp;lt;5.7 kg/m2 in females; &amp;lt;7 kg/m2 in males). Waist circumference (wc)≥80 cm (females) and 90 cm (males) was used to define abdominal obesity. SO was defined as (1) co-existence of sarcopenia and obesity; or (2) fat mass to fat-free mass (FM/FFM) ratio&amp;gt;0.8. Cognition was assessed using Repeatable Battery for the Assessment of Neuropsychological Status. Results: The distribution by body composition based on definition muscle mass and wc was: nonsarcopenic nonobese, 20.3%; nonsarcopenic obese, 55.1%; sarcopenic nonobese, 13.2%; sarcopenic obese, 11.4%. In contrast, the prevalence of sarcopenic obesity based on FM/FFM ratio was 20.2%. The sarcopenic obese group had the lowest total and index RBANS scores(p&amp;lt;0.05). Multiple linear regression showed SO defined by FM/FFM ratio was significantly associated with reduced total score even after adjusting for demographics with β=-1.66 (95% CI -2.74 to -0.59; p=0.002), and demographics, education and clinical covariates with β=-1.14 (95% CI -2.14 to -0.14; p=0.026). SO was significantly associated with reduced index scores for immediate memory and language in fully adjusted models with β=-1.81 (95% CI -3.46 to -0.16; p=0.032) and β =-2.34 (95% CI -4.06 to -0.062; p=0.008) respectively. Conclusions: The differing prevalence of SO based on different measures calls for need to standardize definition. SO was associated with reduced cognitive performance and should be considered in management of cognition in patients with T2D. Disclosure K. Low: None. S. Lim: None. K. Ang: None. S. Tavintharan: None. C. Sum: None. Funding National Medical Research Council of Australia (NMRC/CIRG/1398/2014)

The presence of cerebral white matter lesions and lower skin microvascular perfusion predicts lower cognitive performance in type 1 diabetes patients with retinopathy but not in healthy controls-A longitudinal study.

ObjectiveCognitive impairments in type 1 diabetes may result from hyperglycemia‐associated cerebral microangiopathy. We aimed to identify cerebral microangiopathy and skin microvascular dysfunction—as a surrogate marker for generalized microvascular function—as predictors of cognitive performance over time.MethodsIn this prospective cohort study, 25 type 1 diabetes patients with proliferative retinopathy and 25 matched healthy controls underwent neurocognitive testing at baseline and after follow‐up (3.8 ± 0.8 years). At baseline, 1.5‐T cerebral magnetic resonance imaging was used to detect WML and cerebral microbleeds. Skin capillary perfusion was assessed by means of capillary microscopy.ResultsIn type 1 diabetes patients, but not in healthy controls, the presence of WML (ß = −0.419; P = 0.037) as well as lower skin capillary perfusion (baseline: ß = 0.753; P < 0.001; peak hyperemia: ß = 0.743; P = 0.001; venous occlusion: ß = 0.675; P = 0.003; capillary recruitment: ß = 0.549; P = 0.022) at baseline was associated with lower cognitive performance over time, independent of age, sex, HbA1c, and severe hypoglycemia. The relationship between WML and lower cognitive performance was significantly reduced after adjusting for capillary perfusion.ConclusionsThese data fit the hypothesis that cerebral microangiopathy is a manifestation of generalized microvascular dysfunction, leading to lower cognitive performance.

The auditory P300 component of ERPs elicited during the oddball paradigm in type 2 diabetic patients

Background: There is increasing interest in the impact of diabetes mellitus on cognitive functioning. Several studies found evidence of decreased cognitive performance in type 2 diabetics (T2DM). Since the P300 component of event-related potentials (ERPs) provides valuable information concerning cognition, we studied this component of ERPs in T2DM. Methods: Auditory P300 event-related potentials (P300) were elicited in 43 T2DM patients and 29 age and sex-matched healthy volunteers by use of the auditory oddball paradigm, taking into account the age of the subjects, disease duration and the metabolic control. Results: Compared with controls, diabetics had significantly longer P300 latencies (F= 5.05, p= 0.026) and lower P300 amplitudes both in Cz and Pz electrode positions (F= 8.01, p= 0.005 and F= 13.67, p= 0.000 respectively). In addition, a significant inverse correlation between P300 latency and amplitude was observed in diabetics both in Cz and Pz electrode positions (r= -0.43, p= 0.003 and r= -0.39, p= 0.01 respectively), whereas essentially no relationship between amplitude and latency was observed for the control group. N200 and P300 latencies and the reduction in their amplitudes in Cz and Pz leads were not related to either disease duration or metabolic control. Conclusions: The observed electrophysiological abnormalities may reflect impairment of information processing and working memory, possibly associated with an accelerated ageing process. Our findings suggest that surface-recorded ERPs may be useful for detecting and monitoring the changes in brain function associated with diabetes mellitus.

The effect of educational intervention on glycemic control and cognitive performance in type 2 diabetic inpatients

The effect of educational intervention on glycemic control and cognitive performance in type 2 diabetic inpatients

Relationship between Duration of Diabetes &amp; Cognitive Performance in Type II Diabetes Mellitus Patients

Relationship between Duration of Diabetes &amp; Cognitive Performance in Type II Diabetes Mellitus Patients

Beneficial Effects of Yogasanas and Pranayama in limiting the Cognitive decline in Type 2 Diabetes.

Out of many complications that were observed in type 2 diabetes, cognitive impairment is the most neglected. The aim of the present study is to assess the cognitive decline in type 2 diabetes and to observe the role of yogasanas and pranayama in ameliorating the cognitive decline. Sixty eight type 2 diabetic subjects were recruited in the study, 34 of them did specific yogasanas and pranayama (test group) for six months and the remaining age and sex matched 34 subjects were recruited as (control group) who were not on any specific exercise regimen. Glycaemic index was estimated by measuring the glycosylated haemoglobin (HbA1c) concentration with Bio-Rad apparatus and cognition was assessed by using Addenbrook's Cognitive Examination-Revised (ACE-R), which is a neuropsychological battery. Data was analysed with unpaired student t test. P value<0.05 is considered as statistically significant. Validity was assessed by receiver operating characteristics. Analysis of data indicated more cognitive scores in the test group when compared with the control group. In test group six months practice of yogasanas and pranayama has also significantly brought down the high glycaemic values which were observed in the control group. These findings allow the study to conclude that regular practice of yogasanas and pranayama has a beneficial effect on cognitive performance in type 2 diabetic subjects by stabilizing blood glucose.

Dopamine pathway gene variants may modulate cognitive performance in the DHS - Mind Study.

BackgroundThere is an established association between type 2 diabetes and accelerated cognitive decline. The exact mechanism linking type 2 diabetes and reduced cognitive function is less clear. The monoamine system, which is extensively involved in cognition, can be altered by type 2 diabetes status. Thus, this study hypothesized that sequence variants in genes linked to dopamine metabolism and associated pathways are associated with cognitive function as assessed by the Digit Symbol Substitution Task, the Modified Mini‐Mental State Examination, the Stroop Task, the Rey Auditory‐Verbal Learning Task, and the Controlled Oral Word Association Task for Phonemic and Semantic Fluency in the Diabetes Heart Study, a type 2 diabetes‐enriched familial cohort (n = 893).MethodsTo determine the effects of candidate variants on cognitive performance, genetic association analyses were performed on the well‐documented variable number tandem repeat located in the 3' untranslated region of the dopamine transporter, as well as on single‐nucleotide polymorphisms covering genes in the dopaminergic pathway, the insulin signaling pathway, and the convergence of both. Next, polymorphisms in loci of interest with strong evidence for involvement in dopamine processing were extracted from genetic datasets available in a subset of the cohort (n = 572) derived from Affymetrix® Genome‐Wide Human SNP Array 5.0 and 1000 Genomes imputation from this array.ResultsThe candidate gene analysis revealed one variant from the DOPA decarboxylase gene, rs10499695, to be associated with poorer performance on a subset of Rey Auditory‐Verbal Learning Task measuring retroactive interference (P = 0.001, β = −0.45). Secondary analysis of genome‐wide and imputed data uncovered another DOPA decarboxylase variant, rs62445903, also associated with retroactive interference (P = 7.21 × 10−7, β = 0.3). These data suggest a role for dopaminergic genes, specifically a gene involved in regulation of dopamine synthesis, in cognitive performance in type 2 diabetes.

Continuous Glucose Monitoring and Cognitive Performance in Type 2 Diabetes

Type 2 diabetes is associated with reductions in cognitive function that are associated with glycated hemoglobin (HbA1c) levels, but there is no information on whether cognition is related to postmeal glucose spikes. We explored the relationship of cognition to glucose levels measured by a continuous glucose monitoring system (CGMS) both before and after a weight loss diet. Forty-four white subjects with type 2 diabetes (59.0 ± 6.2 years old; body mass index, 32.8 ± 4.2 kg/m(2); HbA1c, 6.9 ± 1.0%) completed an 8-week energy-restricted (approximately 6-7 MJ, 30% deficit) diet. Cognitive functioning (short-term memory, working memory, speed of processing [inspection time], psychomotor speed, and executive function) was assessed during four practice sessions, baseline, and Week 8. Parallel glucose levels were attained using the CGMS in 27 subjects. Outcomes were assessed by fasting blood glucose (FBG), postprandial peak glucose (G(max)), time spent >12 mmol/L (T > 12), and 24-h area under the glucose curve (AUC(24)). Despite a fall in FBG of 0.65 mmol/L after 8 weeks, digits backward results correlated with FBG at both Week 0 and Week 8 (r = -0.43, P < 0.01 and r = -0.32, P < 0.01, respectively). Digits forward results correlated with FBG (r = -0.39, P < 0.01), G(max) (r = -0.46, P < 0.05), and AUC(24) (r = -0.50, P < 0.01) at Week 0 and FBG (r = -0.59, P < 0.001), G(max) (r = 0.37, P = 0.01), AUC(24) (r = -0.41, P < 0.01), and percentage weight loss (r = 0.31, P < 0.01) at Week 8. Cognitive function was not altered by weight loss, gender, baseline lipid levels, or premorbid intelligence levels (National Adult Reading Test). FBG, G(max,) and AUC(24) were related to cognitive function and an energy-restricted diet for 8 weeks did not alter this relationship.

Auditory P300 event-related potentials in patients with type 2 diabetes mellitus

Background: There is increasing interest in the impact of diabetes mellitus on cognitive functioning. Several studies found evidence of decreased cognitive performance in type 2 diabetics (T2DM). Since the P300

Glycemic Control and Hypoglycemia: Is the Loser the Winner?

The study by Musen et al. (1) evaluated the effect of severe hypoglycemia in intensive diabetes treatment with respect to cognitive performance in type 1 diabetic patients aged 13–19 years at entry into the Diabetes Control and Complications Trial (DCCT). The investigators concluded that …