scholarly journals Metformin Use and Cognitive Function in Older Adults With Type 2 Diabetes Following a Mediterranean Diet Intervention

2021 ◽  
Vol 8 ◽  
Author(s):  
Natalia Soldevila-Domenech ◽  
Aida Cuenca-Royo ◽  
Nancy Babio ◽  
Laura Forcano ◽  
Stephanie Nishi ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Glycemic Control ◽  
Executive Functions ◽  
Mediterranean Diet ◽  
Energy Restriction ◽  
Neuroprotective Effects ◽  
Global Cognition ◽  
Control Trajectory

Background and Purpose: Both adherence to the Mediterranean diet (MedDiet) and the use of metformin could benefit the cognitive performance of individuals with type 2 diabetes, but evidence is still controversial. We examined the association between metformin use and cognition in older adults with type 2 diabetes following a MedDiet intervention.Methods: Prospective cohort study framed in the PREDIMED-Plus-Cognition sub-study. The PREDIMED-Plus clinical trial aims to compare the cardiovascular effect of two MedDiet interventions, with and without energy restriction, in individuals with overweight/obesity and metabolic syndrome. The present sub-study included 487 cognitively normal subjects (50.5% women, mean ± SD age of 65.2 ± 4.7 years), 30.4% of them (N = 148) with type 2 diabetes. A comprehensive battery of neurocognitive tests was administered at baseline and after 1 and 3 years. Individuals with type 2 diabetes that exhibited a good glycemic control trajectory, either using or not using metformin, were compared to one another and to individuals without diabetes using mixed-effects models with inverse probability of treatment weights.Results: Most subjects with type 2 diabetes (83.1%) presented a good and stable glycemic control trajectory. Before engaging in the MedDiet intervention, subjects using metformin scored higher in executive functions (Cohen's d = 0.51), memory (Cohen's d = 0.38) and global cognition (Cohen's d = 0.48) than those not using metformin. However, these differences were not sustained during the 3 years of follow-up, as individuals not using metformin experienced greater improvements in memory (β = 0.38 vs. β = 0.10, P = 0.036), executive functions (β = 0.36 vs. β = 0.02, P = 0.005) and global cognition (β = 0.29 vs. β = −0.02, P = 0.001) that combined with a higher MedDiet adherence (12.6 vs. 11.5 points, P = 0.031). Finally, subjects without diabetes presented greater improvements in memory than subjects with diabetes irrespective of their exposure to metformin (β = 0.55 vs. β = 0.10, P < 0.001). However, subjects with diabetes not using metformin, compared to subjects without diabetes, presented greater improvements in executive functions (β = 0.33 vs. β = 0.08, P = 0.032) and displayed a higher MedDiet adherence (12.6 points vs. 11.6 points, P = 0.046).Conclusions: Although both metformin and MedDiet interventions are good candidates for future cognitive decline preventive studies, a higher adherence to the MedDiet could even outweigh the potential neuroprotective effects of metformin in subjects with diabetes.

Effect of Advanced Glycation End Products on Cognition in Older Adults with Type 2 Diabetes: Results from a Pilot Clinical Trial

2021 ◽  
pp. 1-11
Author(s):  
Roni Lotan ◽  
Ithamar Ganmore ◽  
Abigail Livny ◽  
Nofar Itzhaki ◽  
Mark Waserman ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Pilot Trial ◽  
Advanced Glycation ◽  
Glycation End Products ◽  
End Products ◽  
Global Cognition

Background: Dietary advanced glycation end-products (AGEs) are linked to cognitive decline. However, clinical trials have not tested the effect of AGEs on cognition in older adults. Objective: The aim of the current pilot trial was to examine the feasibility of an intervention to reduce dietary AGEs on cognition and on cerebral blood flow (CBF). Methods: The design is a pilot randomized controlled trial of dietary AGEs reduction in older adults with type 2 diabetes. Seventy-five participants were randomized to two arms. The control arm received standard of care (SOC) guidelines for good glycemic control; the intervention arm, in addition to SOC guidelines, were instructed to reduce their dietary AGEs intake. Global cognition and CBF were assessed at baseline and after 6 months of intervention. Results: At baseline, we found a reverse association between AGEs and cognitive functioning, possibly reflecting the long-term toxicity of AGEs on the brain. There was a significant improvement in global cognition at 6 months in both the intervention and SOC groups which was more prominent in participants with mild cognitive impairment. We also found that at baseline, higher AGEs were associated with increased CBF in the left inferior parietal cortex; however, 6 months of the AGEs lowering intervention did not affect CBF levels, despite lowering AGEs exposure in blood. Conclusion: The current pilot trial focused on the feasibility and methodology of intervening through diet to reduce AGEs in older adults with type 2 diabetes. Our results suggest that participants with mild cognitive impairment may benefit from an intensive dietary intervention.

scholarly journals Effects of low-intensity resistance training on muscular function and glycemic control in older adults with type 2 diabetes

2018 ◽  
Vol 10 (2) ◽  
pp. 331-338 ◽  
Author(s):  
Eri Takenami ◽  
ShinMin Iwamoto ◽  
Noriko Shiraishi ◽  
Akiko Kato ◽  
Yuichi Watanabe ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Resistance Training ◽  
Glycemic Control ◽  
Low Intensity ◽  
Muscular Function

scholarly journals Specific Dimensions of Depression Have Different Associations With Cognitive Decline in Older Adults With Type 2 Diabetes

2021 ◽  
Author(s):  
Laili Soleimani ◽  
Ramit Ravona-Springer ◽  
Hung-Mo Lin ◽  
Xiaoyu Liu ◽  
Mary Sano ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Executive Functions ◽  
Cognitive Decline ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Random Coefficients ◽  
Neuropsychological Battery ◽  
Five Dimensions

Objective: Depression is highly frequent in older adults with Type 2 Diabetes and is associated with cognitive impairment. Yet, little is known about how various depression dimensions differentially affect cognition. We investigated longitudinal associations of specific depression dimensions with cognitive decline. <p> </p> <p>Research Design and Methods: Participants (N=1002) were from the Israel Diabetes and Cognitive Decline study, 65+ years of age with Type 2 Diabetes, not demented at baseline. Participants underwent comprehensive neuropsychological battery at baseline and every 18 months thereafter including domains of Episodic Memory, Attention/Working Memory, Semantic Categorization/Language, Executive Function and Z scores of each domain were averaged and further normalized to calculate Global Cognition. Depression items from Geriatric Depression Scale- 15 items (GDS-15) was measured at each visit and subcategorized to five dimensions: Dysphoric Mood, Withdrawal Apathy-Vigor (entitled apathy), Anxiety, Hopelessness and Memory complaint. Random coefficients models examined association of depression dimensions with baseline and longitudinal cognitive functioning adjusting for socio-demographics and baseline characteristics, including cardiovascular risk factors, physical activity and use of diabetic medications. </p> <p> </p> <p>Result: In the fully adjusted model, at baseline, all dimensions of depression, except for anxiety, were associated with some aspects of cognition (p-values from .01 to <.001). Longitudinally, greater apathy scores were associated with faster decline in executive functions (p=.004), a results that withstood adjustment for multiple comparisons. Associations of other depression dimensions with cognitive decline were not significant (p>0.01).</p> <p> </p> <p>Conclusion: Apathy was associated with a faster cognitive decline in executive functions. These findings highlight the heterogeneity of depression as a clinical construct rather than a single entity and point to apathy as a specific risk factor for cognitive decline among older adults with Type 2 Diabetes. </p>

1407-P: Predictors of Glycemic Control among Older Adults with Type 2 Diabetes Stratified by Living Environment

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1407-P
Author(s):  
APRILL Z. DAWSON ◽  
KAIWEI LU ◽  
REBEKAH J. WALKER ◽  
LEONARD E. EGEDE
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Glycemic Control ◽  
Living Environment

Effect of psychotherapy for depression via home telehealth on glycemic control in adults with type 2 diabetes: Subgroup analysis of a randomized clinical trial

2017 ◽  
Vol 24 (9) ◽  
pp. 596-602 ◽  
Author(s):  
Leonard E Egede ◽  
Rebekah J Walker ◽  
Elizabeth H Payne ◽  
Rebecca G Knapp ◽  
Ronald Acierno ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Glycemic Control ◽  
Subgroup Analysis ◽  
Repeated Measures ◽  
Controlled Trial ◽  
Treatment Groups ◽  
Design And Methods ◽  
The Impact

Objective We evaluated the impact of telemedicine-delivered behaviour activation treatment (BAT) on glycemic control in a subgroup of older adults with diabetes who participated in a randomized controlled trial for depression. Research design and methods We randomized older adults with major depression to same-room or telemedicine BAT. Each group received eight weekly sessions. For the subgroup analysis, we identified individuals with type 2 diabetes and obtained hemoglobin A1c at baseline and 12 months’ follow-up. We used mixed-effects models (MEM) for repeated measures analysis to compare the longitudinal mean A1c. We estimated model-derived mean A1c values and considered an adjusted model to account for baseline health status. Results We included 90 individuals with type 2 diabetes of the original 241 in the subgroup analysis (43 in telemedicine and 47 in same room). Treatment groups were not significantly different at baseline for demographics, depression, anxiety or A1c levels (telemedicine 6.9 vs. same room 7.3, p = 0.19). Baseline mean A1c for the telemedicine group remained at 6.9 (55 mmol/mol) at 12 months, whereas baseline mean A1c for the same-room group increased to 7.7 (61 mmol/mol). Longitudinal trajectories of model-derived mean A1c indicated a significant main effect of treatment group on mean A1c value at study end (difference = −0.82, 95% CI −1.41, −0.24). Adjusted analyses gave comparable results. Conclusions Telemedicine-delivered BAT was superior to same room in achieving lower mean A1c values in participants with type 2 diabetes, suggesting BAT-delivered via telemedicine is a viable treatment option for adults with diabetes.

scholarly journals Mediterranean Diet and Type 2 Diabetes Mellitus: A Perpetual Inspiration for the Scientific World. A Review

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1307
Author(s):  
Tatjana Milenkovic ◽  
Nadica Bozhinovska ◽  
Djuro Macut ◽  
Jelica Bjekic-Macut ◽  
Dario Rahelic ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
At Risk ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Mediterranean Diet ◽  
The Balkans ◽  
The Past ◽  
The Mediterranean

For the past 80 years, the effect of the Mediterranean diet on overall health has been a constant topic of interest among medical and scientific researchers. Parallel with the persistent global rise of cases of type 2 diabetes, many studies conducted in the past 20 years have shown the benefits of the Mediterranean lifestyle for people with, or at risk of developing, type 2 diabetes mellitus. However, despite the large body of evidence, concerns exist amongst scientists regarding the reliability of the data related to this topic. This review offers a glimpse of the onset of the Mediterranean diet and follows its significant impact on the prevention and treatment of type 2 diabetes. There is a constant rise in type 2 diabetes cases on the Balkan Peninsula and North Macedonia in particular. Having in mind that North Macedonia, as well as most of the countries on the Balkans have low to middle income, there is a need for a certain affordable dietary pattern to ameliorate the rise in diabetes incidence, as well as improve the glycemic control. We did a review based on the available literature regarding Mediterranean diet and people with or at risk of developing type 2 diabetes mellitus, its effects on glycemic control, lipid profile and metabolic outcome.

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