Cross‐sectional association of metrics derived from continuous glucose monitoring with cognitive performance in older adults with type 2 diabetes

Abstract

Aim To examine the association between continuous glucose monitoring (CGM)‐derived metrics and cognitive performance in older adults with type 2 diabetes (T2D). Materials and methods A total of 100 outpatients with T2D aged 70 years or older were analysed. Participants underwent CGM for 14 days. As CGM‐derived metrics, mean sensor glucose (SG), glucose coefficient of variation (CV), time in range (TIR; 70‐180 mg/dl), time above range (TAR; > 180 mg/dl) and time below range (TBR; < 70 mg/dl), were calculated. Participants underwent cognitive tests, including the Japanese version of the Montreal Cognitive Assessment (MoCA‐J), a delayed word‐recall test from the Alzheimer's Disease Assessment Scale‐cognitive subscale, a digit symbol substitution test, a letter word fluency test, a trail‐making test (TMT) and digit span test (DSP). Results In multiple regression analyses adjusted for confounders, a higher mean SG was associated with a lower performance in MoCA‐J and TMT part B (TMT‐B) (P < .05). A higher TAR was associated with a lower performance in TMT‐B and DSP‐backward (P < .05). By contrast, a higher TIR was associated with better function in TMT‐B and DSP‐backward (P < .05). Furthermore, CV and TBR were not associated with any cognitive function. Conclusion Hyperglycaemia metrics and TIR derived from CGM are associated with cognitive functions, especially with executive function and working memory, in older adults with T2D.

Relationship between key continuous glucose monitoring-derived metrics and specific cognitive domains in patients with type 2 diabetes mellitus

“…Some studies have shown that TIR is closely related to cognitive dysfunction [8,22]. Contrary to a previous study, we did not observe a relationship between TIR and global cognition or speci c cognitive domains.…”

“…Therefore, it is recommended that the glycemic control target value should be relaxed for T2DM patients with cognitive impairment. One study demonstrated that a higher TAR > 10.0 mmol/L was associated with a lower performance in executive functioning and working memory [22]. Our results are in line with the study discussed above.…”

“…To date, many studies have revealed that hyperglycemia is strongly correlated with cognitive impairment [21,22]. TAR and FPG are the main metrics of hyperglycemia.…”

Longitudinal association of continuous glucose monitoring‐derived metrics with cognitive decline in older adults with type 2 diabetes: A 1‐year prospective observational study

“…However, the COVID-19 pandemic affected recruitment and assessment, and as described in the previous study, 9 Of 100 participants, we included those who completed the MoCA-J at baseline and 1-year follow-up, which was performed from February 2022 to February 2023.…”

“…Significant cross-sectional associations were observed between hyperglycaemia/hypoglycaemia and poor cognitive performance and between a high TIR and a better cognitive performance. [9][10][11] However, their longitudinal relationships remained unclear.…”