Positive Association between Preserved C-Peptide and Cognitive Function in Pregnant Women with Type-1 Diabetes

Abstract

This study focused on the cognitive function of women with type 1 diabetes in pregnancy. We investigated risk factors for a low cognitive score such as age, duration of Diabetes, BMI, subclinical hypothyroidism, cardiovascular autonomic neuropathy, the impact of hypo-/hyperglycemia, and C-peptide preservation. Material and methods. Seventy-eight pregnant women with type 1 diabetes (age 31.1 ± 5.4 years, diabetes duration 14.3 ± 8.9 years) were included in the study. Cognitive function was assessed in different domains, such as reasoning, memory, attention, coordination, and perception. Results. The cognitive test values ≥400 were considered high scores, and values <400 were considered low. Relative risks for low scores for general cognitive function were associated with increased BMI > 25 kg/m2 2.208 (95% CI 1.116–4.370), HbA1c > 6.5% RR 0.774 (95% CI 0.366–1.638), subclinical hypothyroidism RR 3.111 (95% CI 1.140–8.491), and impaired cardiovascular autonomic neuropathy RR 2.250 (95% CI 1.000–5.062). Pregnant women with a lower score for general cognitive function had higher BMI and higher leptin levels. Preserved C-peptide reduces the risk for cognitive impairment (RR 0.297 (95% CI 0.097–0.912)) in pregnant women with type 1 diabetes Conclusion. BMI > 25 kg/m2, subclinical hypothyroidism, and cardiovascular autonomic neuropathy are associated with increased risk, and postprandial C-peptide preservation with reduced risk for cognitive impairment in pregnant women with type 1 diabetes.

Global cognition and executive functions of older adults with type 1 diabetes mellitus without dementia

“…Despite the homogeneous patient population, there were significant differences in C‐peptide levels, which represents insulin secretion, and the BMI, which affected insulin resistance in our study, between type 1 diabetes mellitus and type 2 diabetes mellitus. The differences in cognitive and executive functions between type 1 diabetes mellitus and type 2 diabetes mellitus might have been influenced by insulin deficiency in type 1 diabetes mellitus and insulin resistance in type 2 diabetes mellitus 52 , 53 , 54 , 55 . Furthermore, cognitive function in the elderly with type 1 diabetes mellitus has been reported in Europe and the USA 10 , 15 , 16 .…”