Introduction: DM provokes peripheral complications and changes in central nervous system. Central changes in the course of diabetes mellitus (DM) include changes in brain tissue structure, electrophysiological abnormalities but also disturbances in neurotransmission leading to cognitive decline.
Aim of the study: The aim of our study was to asses cognitive functioning of patients suffering from DM1 for at least 5 years but without any diagnosed complications.
Materials and methods: Cognitive functions were assessed in 59 patients (35 men) with Trail Making Test A (TMT A) and B (TMT B), Maze Test (MT), Stroop Test (SCWT) and Rey Auditory Verbal Learning Test (RAVLT). Mental disorders were excluded with Beck’s Depression Inventory (BT), Mini Mental State Examination (MMSE) and psychiatric examination.
Results: We stated that women, compared with men, presented worsening of executive functions, speed and motor control. Cognitive decline depended on number of episodes of at least moderate hypoglycemia and duration of disease. HbA1c below 8% resulted in better memory, speed and motor control. Cognitive decline was more escalated in the patients with atherogenic lipid profile.
Conclusions: It seems that even apparent lack of complications is not unambiguous with lack of cognitive decline and women seem to be more susceptible. DM1 affects young individuals, whose cognitive functions are in the course of the development, so it is important to find the underlying mechanisms and the areas of disturbed cognitive functioning and further investigations are needed.
If the inline PDF is not rendering correctly, you can download the PDF file here.
1. McCrimmon RJ Ryan CM Frier BM. Diabetes and cognitive dysfunction. Lancet 2012; 379: 2291-2299.
2. Prasad S Sajja RK Naik P Cucullo L. Diabetes Mellitus and Blood-Brain Barrier Dysfunction: An Overview. J Pharmacovigil 2014; 2: 125.
3. Chmiel-Perzyńska I Perzyński A Urbańska EM. Experimental diabetes mellitus type 1 increases hippocampal content of kynurenic acid in rats. Pharmacol Rep. 2014; 66: 1134-1139.
4. Murray AM Barzilay JI Lovato JF et al. Action to Control Cardiovascular Risk in Diabetes Memory in Diabetes (ACCORD-MIND) Biomarkers of renal function and cognitive impairment in patients with diabetes. Diabetes Care 2011; 34: 1827-1832.
5. Hugenschmidt CE Lovato JF Ambrosius WT et al. The cross-sectional and longitudinal associations of diabetic retinopathy with cognitive function and brain MRI findings: the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. Diabetes Care 2014; 37: 3244-3252.
6. Cato MA Mauras N Ambrosino J et al. Diabetes Research in Children Network (DirecNet). Cognitive functioning in young children with type 1 diabetes. J Int Neuropsychol Soc 2014; 20: 238-247.
7. Tonoli C Heyman E Roelands B et al. Type 1 diabetes-associated cognitive decline: a meta-analysis and update of the current literature. J Diabetes 2014; 6: 499-513.
8. Verdelho A Madureira S Ferro JM et al. LADIS Study. Differential impact of cerebral white matter changes diabetes hypertension and stroke on cognitive performance among non-disabled elderly. The LADIS study. J Neurol Neurosurg Psychiatry 2007; 78: 1325-1330.
9. Tolu-Kendir O Kiriş N Temiz F et al. Relationship between metabolic control and neurocognitive functions in children diagnosed with type I diabetes mellitus before and after 5 years of age. Turk J Pediatr 2012; 54: 352-361.
10. McGuinness B Craig D Bullock R Passmore P. Statins for the prevention of dementia. Cochrane Database Syst Rev 2009; 2: CD003160.