scholarly journals Markers of cognitive impairment in patients with type 2 diabetes

2016 ◽  
Vol 24 (2) ◽  
pp. 161-176 ◽  
Author(s):  
Simona Cernea ◽  
Floredana-Laura Şular ◽  
Adina Huţanu ◽  
Septimiu Voidăzan
Keyword(s):  
Type 2 Diabetes ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Statistical Significance ◽  
High Sensitivity ◽  
Cognitive Status ◽  
Cross Sectional ◽  
Delayed Recall ◽  
Significant Difference

Abstract Background. The study aimed to evaluate the correlations of cognitive function with metabolic, nutritional, hormonal and immunologic parameters in patients with type 2 diabetes (T2D), in order to identify markers of cognitive impairment. Material and methods. This cross-sectional study included 216 T2D patients and 23 healthy individuals (HC). The cognitive status was evaluated by the MoCA test. From HC and 145 T2D patients several parameters were also determined: C-peptide, vitamin B12, high-sensitivity CRP (by chemiluminescent immunometric assay), HbA1c, lipids, cortisol, TSH, Mg (by a Cobas 6000 analyzer), glucose (by glucose-oxidase method) and leptin and adiponectin (by ELISA method). Statistical significance was set at p < 0.05. Results. There was a significant difference in the MoCA scores between HC and T2D groups (26.0(17.0-29.0) vs. 23.0(13.0- 31.0) points; p: 0.004). T2D patients with cognitive dysfunction were significantly older and less formally educated (p < 0.0001). Age negatively correlated with MoCA scores (-0.31; 95%CI:-0.42,-0.18; p < 0.0001). T2D patients had significantly lower visuospatial/executive (4.0(0.0-5.0) vs. 5.0(2.0-5.0) points; p: 0.04) and delayed recall scores (2.0(0.0- 5.0) vs. 3.0(1.0-5.0) points; p: 0.03) and lower serum Mg concentrations (0.81(0.12-0.99) vs. 0.92(0.41-1.35) mmol/l, p < 0.0001). Serum Mg levels positively correlated with MoCA scores (0.24, 95%CI: 0.07, 0.39; p: 0.003) and with visuospatial/ executive (0.30; 95%CI: 0.14, 0.45; p: 0.0002) and naming functions (0.18; 95%CI: 0.01, 0.34; p: 0.02). Conclusions. Patients with T2D had significant cognitive impairment, with decrements in the visuospatial/executive and delayed recall domains. Younger age and higher education correlated with better cognitive function. Serum Mg levels correlated positively with overall cognitive function and with visuospatial/executive and naming domains.

scholarly journals Associations between plasma kynurenines and cognitive function in individuals with normal glucose metabolism, prediabetes and type 2 diabetes: the Maastricht Study

Diabetologia ◽  
2021 ◽  
Vol 64 (11) ◽  
pp. 2445-2457
Author(s):  
Lieke Bakker ◽  
Inez H. G. B. Ramakers ◽  
Martin P. J. van Boxtel ◽  
Miranda T. Schram ◽  
Coen D. A. Stehouwer ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Glucose Metabolism ◽  
Xanthurenic Acid ◽  
Cross Sectional ◽  
Lower Odds ◽  
Normal Glucose ◽  
Hydroxyanthranilic Acid

Abstract Aims/hypothesis Studies investigating associations between kynurenines and cognitive function have generally been small, restricted to clinical samples or have found inconsistent results, and associations in the general adult population, and in individuals with type 2 diabetes in particular, are not clear. Therefore, the aim of the present study was to investigate cross-sectional associations between plasma kynurenines and cognitive function in a cohort of middle-aged participants with normal glucose metabolism, prediabetes (defined as impaired fasting glucose and/or impaired glucose tolerance) and type 2 diabetes. Methods Plasma kynurenines were quantified in 2358 participants aged 61 ± 8 years. Cross-sectional associations of kynurenines with cognitive impairment and cognitive domain scores were investigated using logistic, multiple linear and restricted cubic spline regression analyses adjusted for several confounders. Results Effect modification by glucose metabolism status was found for several associations with cognitive impairment, hence analyses were stratified. In individuals with prediabetes, 3-hydroxykynurenine (OR per SD 0.59 [95% CI 0.37, 0.94]) and 3-hydroxyanthranilic acid (0.67 [0.47, 0.96]) were associated with lower odds of cognitive impairment after full adjustment. In individuals with type 2 diabetes, kynurenine (0.80 [0.66, 0.98]), 3-hydroxykynurenine (0.82 [0.68, 0.99]), kynurenic acid (0.81 [0.68, 0.96]), xanthurenic acid (0.73 [0.61, 0.87]) and 3-hydroxyanthranilic acid (0.73 [0.60, 0.87]) were all associated with lower odds of cognitive impairment. Kynurenic acid (β per SD 0.07 [95% CI 0.02, 0.13]) and xanthurenic acid (0.06 [0.01, 0.11]) were also associated with better executive function/attention. No associations were observed in individuals with normal glucose metabolism. Conclusions/interpretation Several kynurenines were cross-sectionally associated with lower odds of cognitive impairment and better cognitive functioning in type 2 diabetes, while less widespread associations were seen in prediabetes. Low levels of kynurenines might be involved in the pathway of type 2 diabetes and cognitive decline but this needs further studies. Graphical abstract

scholarly journals The Gaze Fixation Assessed by Microperimetry: A Useful Tool for the Monitoring of the Cognitive Function in Patients with Type 2 Diabetes

2021 ◽  
Vol 11 (8) ◽  
pp. 698
Author(s):  
Ángel Michael Ortiz-Zúñiga ◽  
Olga Simó-Servat ◽  
Alba Rojano-Toimil ◽  
Julia Vázquez-de Sebastian ◽  
Carmina Castellano-Tejedor ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Cognitive Status ◽  
Retinal Sensitivity ◽  
Gaze Fixation ◽  
The Gaze ◽  
State Evaluation

Current guidelines recommend annual screening for cognitive impairment in patients > 65 years with type 2 diabetes (T2D). The most used tool is the mini-mental state evaluation (MMSE). Retinal microperimetry is useful for detecting cognitive impairment in these patients, but there is no information regarding its usefulness as a monitoring tool. We aimed to explore the role of retinal microperimetry in the annual follow-up of the cognitive function of patients with T2D older than 65 years. Materials and Methods: Prospective observational study, comprising patients > 65 years with T2D, attended at our center between March–October 2019. A complete neuropsychological evaluation assessed the baseline cognitive status (mild cognitive impairment, MCI, or normal, NC). Retinal microperimetry (sensitivity, gaze fixation) and MMSE were performed at baseline and after 12 months. Results: Fifty-nine patients with MCI and 22 NC were identified. A significant decline in the MMSE score was observed after 12 months in the MCI group (25.74 ± 0.9 vs. 24.71 ± 1.4; p = 0.001). While no significant changes in retinal sensitivity were seen, all gaze-fixation parameters worsened at 12 months and significantly correlated with a decrease in the MMSE scores. Conclusion: Retinal microperimetry is useful for the monitoring of cognitive decline in patients > 65 years with T2D. Gaze fixation seems a more sensitive parameter for follow-up after 12 months than retinal sensitivity.

Decrease in Serum Levels of Adiponectin and Increase in 8-OHdG: a Culprit for Cognitive Impairment in the Elderly Patients with Type 2 Diabetes

2019 ◽  
Vol 20 (1) ◽  
pp. 44-50 ◽  
Author(s):  
Ting-Fu Huang ◽  
Zhi-Pei Tang ◽  
Shan Wang ◽  
Ming-Wei Hu ◽  
Lu Zhan ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cognitive Impairment ◽  
Elderly Patients ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Serum Levels ◽  
The Elderly ◽  
Cognitive Outcome ◽  
Significant Difference

Background: Adiponectin and 8-Hydroxy-2′-deoxyguanosine (8-OHdG) are identified as important biomarkers in the pathogenesis process of type 2 diabetes mellitus (T2DM). Whether adiponectin and 8-OHdG have a relation to cognitive decline in the elderly T2DM patients has been poorly understood. The aim of this study was to evaluate the effects of adiponectin and 8-OHdG in the elderly patients with T2DM and to determine the role of adiponectin and 8-OHdG in the cognitive impairment of the elderly patients with T2DM. Methods:: 57 individuals were recruited and analyzed , with 26 cases of T2DM without cognitive impairment and 31 cases of T2DM with cognitive impairment. All of them underwent an examination of diabetes scales and blood glucose at different times. A primary diagnosis of diabetes was in line with the diagnosis criteria set by the American Diabetes Association (ADA). Statistical significance was defined as a P-value of less than 0.05. Results:: The variables of sex, age, body mass index (BMI), hypertension, diabetes, metabolic syndrome, lacunar cerebral infarction, smoking and drinking in T2DM patients without cognitive impairment and with cognitive impairment showed no difference according to the univariate analysis exploring each variable separately (p>0.05). A significant difference was observed in the serum levels of adiponectin and 8-OHdG and the scales of MMSE and MoCA (p<0.05). Therefore, it was inferred that there is no correlation between glucose metabolic value and cognitive outcome of T2DM patients. Serum levels of adiponectin and 8-OHdG could act as biomarkers of cognitive impairment degree in the elderly T2DM patients. Conclusion:: Serum levels of adiponectin and 8-OHdG could act as specific and sensitive biomarkers for the early diagnosis and treatment of cognitive impairment in elderly T2DM patients. Serum levels of adiponectin and 8-OHdG have a close relation to the neurological cognitive outcome of the elderly T2DM patients.

ASSESSMENT OF DEMENTIA IN THE TYPE 2 DIABETES BY MOCA

2017 ◽  
pp. 35-44
Author(s):  
Dinh Toan Nguyen
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
High Sensitivity ◽  
Cross Sectional ◽  
Average Value ◽  
Lifestyle Risk ◽  
Diabetes Mellitus Risk

Background: Studies show that diabetes mellitus is the greatest lifestyle risk factor for dementia. Appropriate management and treatment of type 2 diabetes mellitus could prevent the onset and progression of mild cognitive impairment to dementia. MoCA test is high sensitivity with mild dementia but it have not been used and studied widespread in Vietnam. Aim: 1. Using MoCA and MMSE to diagnose dementia in patients with type 2 diabetes mellitus. 2. Assessment of the relationship between dementia and the risk factors. Methods: cross-sectional description in 102 patients with type 2 diabetes mellitus. The Mini-Mental State Examination(MMSE) and the Montreal Cognitive Assessment (MoCA) were used to assess cognitive function. The diagnosis of dementia was made according to Diagnostic and Statistical Manual of Mental Disorders. Results: The average value for MoCA in the group of patients with dementia (15.35 ± 2.69) compared with non-dementia group (20.72 ± 4.53). The sensitivity and specificity of MoCA were 84.8% and 78.3% in identifying individuals with dementia, and MMSE were 78.5% and 82.6%, respectively. Using DSMIV criteria as gold standard we found MoCA and MMSE were more similar for dementia cases (AUC 0.871 and 0.890). The concordance between MoCA and MMSE was moderate (kappa = 0.485). When considering the risk factors, the education,the age, HbA1c, dyslipidemia, Cholesterol total related with dementia in the type 2 diabetes. Conclusion: MoCA scale is a good screening test of dementia in patients with type 2 diabetes mellitus.When compared with the MMSE scale, MoCA scale is more sensitive in detecting dementia. Key words: MoCA, dementia, type 2 diabetes mellitus, risk factors

scholarly journals Relationship of the Self-perception of Lifestyle with Level of Physical Activity in People with and without Type 2 Diabetes

2019 ◽  
pp. 1-7
Author(s):  
Briseida Mayel Perez-Avelino ◽  
Nicolás Padilla-Raygoza ◽  
Verónica Benitez-Guerrero ◽  
María Luisa Sánchez Padilla ◽  
Vicente Beltrán-Campos ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Statistical Significance ◽  
Self Perception ◽  
Chi Square ◽  
Cross Sectional ◽  
Lifestyle Questionnaire ◽  
Chi Square Test ◽  
Relationship Of

Objective: To determine the relationship of the perception of lifestyle with the level of physical activity in people with type 2 diabetes and without type 2 diabetes. Study Design: Analytical cross-sectional observational study in Celaya, Guanajuato, Mexico. Methodology: Sample composed of 100 people with type 2 diabetes and 100 people without type 2 diabetes, the lifestyle questionnaire and IPAQ questionnaire were used. Descriptive statistics were calculated for sociodemographic variables; it was calculated Chi-square test and Odds Ratio.  To demonstrate the statistical significance of results, the value of P was set at .05. Statistical analysis was performed in STATA 13.0 ®. Results: In patients with Type 2 Diabetes predominated females, married, who never went school and elementary and BMI ≥ 25 kg/m2; among patients without Type 2 Diabetes, predominant males, singles, went school or university, BMI ≥25 kg/m2; no relationship was found between lifestyle perception and level of physical activity in adults with type 2 diabetes (X² = 0.0022 gl 1 P = .96) neither it was found a significant relationship between lifestyle perception and level of physical activity in adults without type 2 diabetes (X² = 5.23 gl 1 P = .02 RM = 2.85 95% CI = 0.80 to 10.4). Conclusion: The results show that self-perception of lifestyle and physical activity is different in people with less age, more schooling, males.

scholarly journals The Frequency of Malnutrition in Patients with Type 2 Diabetes

2021 ◽  
Author(s):  
Miraç Vural Keskinler ◽  
Güneş Feyizoğlu ◽  
Kübra Yıldız ◽  
Aytekin Oğuz
Keyword(s):  
Type 2 Diabetes ◽  
Outpatient Clinic ◽  
High Body Mass Index ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Nutritional Risk ◽  
Cross Sectional ◽  
Significant Difference ◽  
Nrs 2002

Objective: Obesity is one of the most common comorbidities of diabetes mellitus (DM) whose frequency is rapidly increasing nowadays. Although obesity caused by excessive and unbalanced nutrition often accompanies diabetes; malnutrition is another complication of diabetes. This study was conducted to investigate the frequency of malnutrition in individuals with diabetes. Method: This study is a cross-sectional study. The patients with type 2 diabetes followed up in the diabetes outpatient clinic of a university hospital between February and March 2018 were included in the study. Anthropometric measurements of the patients and “Nutritional Risk Screening-2002” (NRS-2002) scores were recorded. Results: A total of 222 (F: 132 59.4%) patients were included in the study. When two groups with higher NRS (≥3) and lower NRS (<3) scores less than 3 were compared, any significant difference was not detected between two groups in terms of age, waist circumference and HbA1c values. Only BMI was found to be lower in the group with malnutrition risk (p: 0.030). When the patients were evaluated in terms of diabetes treatments and risk of malnutrition, any significant intergroup difference was not found (p: 0.847). Conclusion: It was found that there is a risk of malnutrition in one of every seven diabetics with a high body mass index who were being followed up in the diabetes outpatient clinic.

scholarly journals Cell-Derived Microparticles in Patients with Type 2 Diabetes Mellitus: a Systematic Review and Meta-Analysis

2016 ◽  
Vol 39 (6) ◽  
pp. 2439-2450 ◽  
Author(s):  
Sheyu Li ◽  
Jia Wei ◽  
Chenghui Zhang ◽  
Xiaodan Li ◽  
Wentong Meng ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Meta Analysis ◽  
Cross Sectional ◽  
Significant Difference ◽  
Different Types ◽  
Mean Differences

Background/Aims: The aim of this study was to assess the association between circulating cell-derived microparticles (MPs) and type 2 diabetes mellitus (T2DM). Methods: A literature search was performed systematically in PubMed and Embase to identify available case-control or cross-sectional studies that compared different types of cell-derived MPs in patients with T2DM and non-diabetic controls. Pooled standardized mean differences (SMDs) of each MP type were pooled using meta-analysis. Results: Forty-eight studies involving 2,460 patients with T2DM and 1,880 non-diabetic controls were included for systematic review and 34 of which were included for quantitative study by meta-analysis. In the overall analysis, the levels of circulating total MPs (TMPs), platelet-derived MPs (PMPs), monocyte-derived MPs (MMPs) and endothelium-derived MPs (EMPs) were significantly higher in T2DM patients than those in controls (TMPs: SMD, 0.64; 95%CI, 0.12∼1.15; P=0.02; PMPs: SMD, 1.19; 95%CI, 0.88∼1.50; P <0.00001; MMPs: SMD, 0.92; 95%CI, 0.66∼1.17; P <0.00001; EMPs: SMD, 0.73; 95%CI, 0.50∼0.96; P <0.00001). Meanwhile, no significant difference was shown in leukocyte-derived MPs (LMPs) level between diabetic and non-diabetic groups (SMD, 0.37; 95%CI, -0.15∼0.89; P=0.17). Conclusions: The counts of TMPs, PMPs, MMPs and EMPs elevated in patients with T2DM. And cell-derived MPs may play a role in the pathogenesis of T2DM.

scholarly journals Relationship between Stage of Diabetic Retinopathy and Pulse Wave Velocity in Japanese Patients with Type 2 Diabetes

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Kumiko Tanaka ◽  
Toshihide Kawai ◽  
Yoshifumi Saisho ◽  
Shu Meguro ◽  
Kana Harada ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Japanese Patients ◽  
Proliferative Retinopathy ◽  
Cross Sectional ◽  
Significant Difference

Objectives. We investigated the relationship between the stage of diabetic retinopathy and pulse wave velocity (PWV).Methods. This was a cross-sectional study of 689 patients (406 men and 283 women) with type 2 diabetes who were admitted to our hospital from 2004 to 2007. Brachial-ankle pulse wave velocity (baPWV) was measured by an arterial pressure measurement device as PWV/ABI. Diagnosis of diabetic retinopathy was made by ophthalmologists based on the Davis classification: no diabetic retinopathy (NDR), simple retinopathy (SDR), pre-proliferative retinopathy (pre-PDR), and proliferative retinopathy (PDR).Results. There was a significant difference in PWV between patients without diabetic retinopathy (1657.0±417.9 m/s (mean ± SD)) and with diabetic retinopathy (1847.1±423.9 m/s) (P<0.001). In addition, the stage of diabetic retinopathy was associated with aortic PWV (1657.0±417.9 m/s in NDR (n=420),1819.4±430.3 m/s in SDR (n=152),1862.1±394.0 m/s in pre-PDR (n=54), and1901.1±433.5 m/s in PDR (n=63) (P<0.001)).Conclusions. In patients with diabetic retinopathy, even in those with SDR, PWV was higher than that in patients without diabetic retinopathy. Physicians should therefore pay attention to the value of PWV and macroangiopathy regardless of the stage of diabetic retinopathy.

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