Relationship between key continuous glucose monitoring-derived metrics and specific cognitive domains in patients with type 2 diabetes mellitus
Abstract Background Continuous glucose monitoring (CGM)-derived time in range (TIR) is closely associated with micro- and macrovascular complications in type 2 diabetes mellitus (T2DM). This study was performed to investigate the relationship between key CGM-derived metrics and specific cognitive do...
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| Format: | Article |
| Language: | English |
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BMC
2023-05-01
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| Series: | BMC Neurology |
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| Online Access: | https://doi.org/10.1186/s12883-023-03242-2 |
| _version_ | 1827943419525201920 |
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| author | Shanshan Dong Lina Wang Chenxu Zhao Rui Zhang Zhaoyu Gao Lei Jiang Yingying Guo Huimin Zhou Shunjiang Xu |
| author_facet | Shanshan Dong Lina Wang Chenxu Zhao Rui Zhang Zhaoyu Gao Lei Jiang Yingying Guo Huimin Zhou Shunjiang Xu |
| author_sort | Shanshan Dong |
| collection | DOAJ |
| description | Abstract Background Continuous glucose monitoring (CGM)-derived time in range (TIR) is closely associated with micro- and macrovascular complications in type 2 diabetes mellitus (T2DM). This study was performed to investigate the relationship between key CGM-derived metrics and specific cognitive domains in patients with T2DM. Methods Outpatients with T2DM who were otherwise healthy were recruited for this study. A battery of neuropsychological tests was performed to evaluate cognitive function, including memory, executive functioning, visuospatial ability, attention, and language. Participants wore a blinded flash continuous glucose monitoring (FGM) system for 72 h. The key FGM-derived metrics were calculated, including TIR, time below range (TBR), time above range (TAR), glucose coefficient of variation (CV), and mean amplitude of glycemic excursions (MAGE). Furthermore, the glycemia risk index (GRI) was also calculated by the GRI formula. Binary logistic regression was used to assess risk factors for TBR, and we further analysed the associations between neuropsychological test results and key FGM-derived metrics with multiple linear regressions. Results A total of 96 outpatients with T2DM were recruited for this study, with 45.8% experiencing hypoglycemia (TBR< 3.9 mmol/L). Spearman analysis results revealed that a higher TBR< 3.9 mmol/L was correlated with worse performance on the Trail Making Test A (TMTA), Clock Drawing Test (CDT), and cued recall scores (P < 0.05). Logistic regression analysis results indicated that the TMTA (OR = 1.010, P = 0.036) and CDT (OR = 0.429, P = 0.016) scores were significant factors influencing the occurrence of TBR< 3.9 mmol/L. Multiple linear regressions further demonstrated that TBR< 3.9 mmol/L (β = -0.214, P = 0.033), TAR> 13.9 mmol/L (β = -0.216, P = 0.030) and TAR10.1–13.9 mmol/L (β = 0.206, P = 0.042) were significantly correlated with cued recall scores after adjusting for confounding factors. However, TIR, GRI, CV and MAGE showed no significant correlation with the results of neuropsychological tests (P > 0.05). Conclusions A higher TBR< 3.9 mmol/L and TAR> 13.9 mmol/L were associated with worse cognitive functions (memory, visuospatial ability, and executive functioning). Conversely, a higher TAR of 10.1–13.9 mmol/L was associated with better memory performance in memory tasks. |
| first_indexed | 2024-03-13T10:15:17Z |
| format | Article |
| id | doaj.art-e6d63608afd34ce18d86a0528c46e0c7 |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-03-13T10:15:17Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
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| series | BMC Neurology |
| spelling | doaj.art-e6d63608afd34ce18d86a0528c46e0c72023-05-21T11:19:33ZengBMCBMC Neurology1471-23772023-05-0123111210.1186/s12883-023-03242-2Relationship between key continuous glucose monitoring-derived metrics and specific cognitive domains in patients with type 2 diabetes mellitusShanshan Dong0Lina Wang1Chenxu Zhao2Rui Zhang3Zhaoyu Gao4Lei Jiang5Yingying Guo6Huimin Zhou7Shunjiang Xu8Department of Endocrinology and Metabolism, The First Hospital of Hebei Medical UniversityDepartment of Endocrinology and Metabolism, The First Hospital of Hebei Medical UniversityDepartment of Endocrinology and Metabolism, The First Hospital of Hebei Medical UniversityCentral Laboratory, The First Hospital of Hebei Medical UniversityCentral Laboratory, The First Hospital of Hebei Medical UniversityCentral Laboratory, The First Hospital of Hebei Medical UniversityDepartment of Endocrinology and Metabolism, The First Hospital of Hebei Medical UniversityDepartment of Endocrinology and Metabolism, The First Hospital of Hebei Medical UniversityCentral Laboratory, The First Hospital of Hebei Medical UniversityAbstract Background Continuous glucose monitoring (CGM)-derived time in range (TIR) is closely associated with micro- and macrovascular complications in type 2 diabetes mellitus (T2DM). This study was performed to investigate the relationship between key CGM-derived metrics and specific cognitive domains in patients with T2DM. Methods Outpatients with T2DM who were otherwise healthy were recruited for this study. A battery of neuropsychological tests was performed to evaluate cognitive function, including memory, executive functioning, visuospatial ability, attention, and language. Participants wore a blinded flash continuous glucose monitoring (FGM) system for 72 h. The key FGM-derived metrics were calculated, including TIR, time below range (TBR), time above range (TAR), glucose coefficient of variation (CV), and mean amplitude of glycemic excursions (MAGE). Furthermore, the glycemia risk index (GRI) was also calculated by the GRI formula. Binary logistic regression was used to assess risk factors for TBR, and we further analysed the associations between neuropsychological test results and key FGM-derived metrics with multiple linear regressions. Results A total of 96 outpatients with T2DM were recruited for this study, with 45.8% experiencing hypoglycemia (TBR< 3.9 mmol/L). Spearman analysis results revealed that a higher TBR< 3.9 mmol/L was correlated with worse performance on the Trail Making Test A (TMTA), Clock Drawing Test (CDT), and cued recall scores (P < 0.05). Logistic regression analysis results indicated that the TMTA (OR = 1.010, P = 0.036) and CDT (OR = 0.429, P = 0.016) scores were significant factors influencing the occurrence of TBR< 3.9 mmol/L. Multiple linear regressions further demonstrated that TBR< 3.9 mmol/L (β = -0.214, P = 0.033), TAR> 13.9 mmol/L (β = -0.216, P = 0.030) and TAR10.1–13.9 mmol/L (β = 0.206, P = 0.042) were significantly correlated with cued recall scores after adjusting for confounding factors. However, TIR, GRI, CV and MAGE showed no significant correlation with the results of neuropsychological tests (P > 0.05). Conclusions A higher TBR< 3.9 mmol/L and TAR> 13.9 mmol/L were associated with worse cognitive functions (memory, visuospatial ability, and executive functioning). Conversely, a higher TAR of 10.1–13.9 mmol/L was associated with better memory performance in memory tasks.https://doi.org/10.1186/s12883-023-03242-2Time below range (TBR)Time in range (TIR)Time above range (TAR)Type 2 diabetes mellitus (T2DM)Cognitive impairment |
| spellingShingle | Shanshan Dong Lina Wang Chenxu Zhao Rui Zhang Zhaoyu Gao Lei Jiang Yingying Guo Huimin Zhou Shunjiang Xu Relationship between key continuous glucose monitoring-derived metrics and specific cognitive domains in patients with type 2 diabetes mellitus BMC Neurology Time below range (TBR) Time in range (TIR) Time above range (TAR) Type 2 diabetes mellitus (T2DM) Cognitive impairment |
| title | Relationship between key continuous glucose monitoring-derived metrics and specific cognitive domains in patients with type 2 diabetes mellitus |
| title_full | Relationship between key continuous glucose monitoring-derived metrics and specific cognitive domains in patients with type 2 diabetes mellitus |
| title_fullStr | Relationship between key continuous glucose monitoring-derived metrics and specific cognitive domains in patients with type 2 diabetes mellitus |
| title_full_unstemmed | Relationship between key continuous glucose monitoring-derived metrics and specific cognitive domains in patients with type 2 diabetes mellitus |
| title_short | Relationship between key continuous glucose monitoring-derived metrics and specific cognitive domains in patients with type 2 diabetes mellitus |
| title_sort | relationship between key continuous glucose monitoring derived metrics and specific cognitive domains in patients with type 2 diabetes mellitus |
| topic | Time below range (TBR) Time in range (TIR) Time above range (TAR) Type 2 diabetes mellitus (T2DM) Cognitive impairment |
| url | https://doi.org/10.1186/s12883-023-03242-2 |
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