Poor Glycemic Control is Correlated with Reduced Cognitive Function in Type 2 Diabetes Mellitus Patients
Introduction: The prevalence of type 2 Diabetes Mellitus (T2DM) in Indonesia is increasing and is known to cause several complications related to the patient’s glycemic control. A chronic hyperglycemic state will lead to microvascular injury of the brain resulting in cognitive impairment as one of the complications of T2DM. Therefore, our present study observed the correlation between glycemic control and cognitive impairment in patients with T2DM.
Methods: This was an observational study with a cross-sectional design of T2DM patients in endocrine outpatient clinics of Dr. Soetomo General Academic Hospital from October 2020 to March 2021. The subjects were recruited consecutively then categorized into groups with controlled (HbA1c < 7%) and uncontrolled (HbA1c ≥ 7%) blood glucose. The cognitive function was evaluated using the AD8 informant-based questionnaire.
Results: A total of 43 adult T2DM patients aged < 65 years were recruited. The incidence of cognitive impairment was not significantly different (p=0.127) between controlled and uncontrolled blood glucose groups. However, HbA1c levels were positively and significantly correlated with AD8 scores (p=0.031, R=0.330). Moreover, the duration of T2DM was found to significantly affect cognitive abnormalities in these patients. (p=0.021).
Conclusion: Poor glycemic control in T2DM patients increased the risk of developing reduced cognitive function.
Tjokroprawiro A. Buku Ajar Ilmu Penyakit dalam. Ed. 2: Fakultas Kedokteran Universitas Airlangga Rumah Sakit Pendidikan Dr. Soetomo Surabaya. Airlangga University Press, 2015.
Federation IDF. IDF Diabetes Atlas 8th Edition. International Diabetes Federation 2017; 905–911.
KemenKes RI. Riset Kesehatan Dasar (Riskesdas) 2018. Jakarta: Badan Penelitian dan Pengembangan Kesehatan Kementrian Kesehatan Republik Indonesia.
Sherwani SI, Khan HA, Ekhzaimy A, et al. Significance of HbA1c Test in Diagnosis and Prognosis of Diabetic Patients. Biomark Insights 2016; 11: BMI-S38440.
Association AD. Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 2014; 37: S81–S90.
Gao Y, Xiao Y, Miao R, et al. The Prevalence of Mild Cognitive Impairment with Type 2 Diabetes Mellitus Among Elderly People in China: a Cross-sectional Study. Arch Gerontol Geriatr 2016; 62: 138–142.
Chen P-H, Cheng S-J, Lin H-C, et al. Risk Factors for the Progression of Mild Cognitive Impairment in Different Types of Neurodegenerative Disorders. Behavioural Neurology.
Saedi E, Gheini MR, Faiz F, et al. Diabetes Mellitus and Cognitive Impairments. World J Diabetes 2016; 7: 412.
Zilliox LA, Chadrasekaran K, Kwan JY, et al. Diabetes and Cognitive Impairment. Curr Diab Rep 2016; 16: 1–11.
Moheet A, Mangia S, Seaquist ER. Impact of Diabetes on Cognitive Function and Brain Structure. Ann N Y Acad Sci 2015; 1353: 60.
Ong PA, Muis A, Rambe AS, et al. Panduan Praktik Klinik Diagnosis dan Penatalaksanaan Demensia. Jakarta: Perhimpunan Dokter Spesialis Saraf Indonesia.
Chin R, Ng A, Narasimhalu K, et al. Utility of the AD8 as a Self-rating Tool for Cognitive Impairment in an Asian Population. American Journal of Alzheimer’s Disease and other Dementias 2013; 28: 284–288.
Zeng L, Josephson SA, Fukuda KA, et al. A Prospective Comparison of Informant-and Performance-Based Dementia Screening Tools to Predict In-hospital Delirium. Alzheimer Dis Assoc Disord 2015; 29: 312.
Usarel C, Dokuzlar O, Aydin AE, et al. The AD8 (Dementia Screening Interview) is a Valid and Reliable Screening Scale not only for Dementia but also for Mild Cognitive Impairment in the Turkish Geriatric Outpatients. Int Psychogeriatr 2019; 31: 223–229.
PERKENI. Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 di Indonesia. PB Perkeni.2021.
Nugroho BAW, Adnyana IMO, Samatra DPGP. Gula Darah tidak Terkontrol sebagai Faktor Risiko Gangguan Fungsi Kognitif pada Penderita Diabetes Melitus Tipe 2 Usia Dewasa Menengah. Medicina (B Aires) 2016; 50: 22–29.
Mimenza-Alvarado AJ, Jiménez-Castillo GA, Yeverino-Castro SG, et al. Effect of Poor Glycemic Control in Cognitive Performance in the Elderly with Type 2 Diabetes Mellitus: The Mexican Health and Aging Study. BMC Geriatr 2020; 20: 1–8.
Lalithambika CV, Arun CS, Saraswathy LA, et al. Cognitive Impairment and its Association with Glycemic Control in Type 2 Diabetes Mellitus Patients. Indian J Endocrinol Metab 2019; 23: 353.
Roy S, Kim N, Desai A, et al. Cognitive Function and Control of Type 2 Diabetes Mellitus in Young Adults. North American Journal of Medical Sciences 2015; 7: 220.
Sengupta P, Ganguly J, Pal S, et al. Pattern of Cognitive Deficits in Vascular Dementia. Indian J Med Res 2019; 149: 503.
Zhang Y-W, Zhang J-Q, Liu C, et al. Memory Dysfunction in Type 2 Diabetes Mellitus Correlates with Reduced Hippocampal CA1 and Subiculum Volumes. Chin Med J (Engl) 2015; 128: 465.
Mallorquí-Bagué N, Lozano-Madrid M, Toledo E, et al. Type 2 Diabetes and Cognitive Impairment in an Older Population with Overweight or Obesity and Metabolic Syndrome: Baseline Cross-sectional Analysis of the PREDIMED-plus study. Sci Rep 2018; 8: 1–9.
Organization WHO. Risk Reduction of Cognitive Decline and Dementia: WHO guidelines.2019
Hazari MAH, Ram Reddy B, Uzma N, et al. Cognitive Impairment in Type 2 Diabetes Mellitus. International Journal of Diabetes Mellitus 2015; 3: 19–24.
Lyu F, Wu D, Wei C, et al. Vascular Cognitive Impairment and Dementia in Type 2 Diabetes Mellitus: An Overview. Life Sciences 2020; 254: 117771.
Prajitno JH, Soelistijo SA, Pranoto A. Simvastatin Effect on High-Sensitivity C-Reactive Protein in Type 2 Diabetes Mellitus. Systematic Reviews in Pharmacy 2020; 11: 618–623.
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