The effect of long-term past glycemic control on executive function among patients with type 2 diabetes mellitus

Minami, Toshihiro; Ito, Yuzuru; Yamada, Masayo; Furuta, Ryutaro; Minagawa, Fuyuki; Kamata, Kentaro; Kameda, Akiko; Terauchi, Yasuo

doi:10.1007/s13340-019-00411-y

Cited by 12 publications

(10 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…T2DM can be applied as an individual independent risk factor for Alzheimer’s disease (AD), vascular dementia (VD), and mild cognitive impairment (MCI) ( Moon et al, 2016 ). Patients with T2DM have more executive dysfunction than individuals without diabetes ( Minami et al, 2020 ), which is related to mild-to-moderate EF decreases ( Vincent and Hall, 2015 ). EF decreases in T2DM patients than in healthy older controls but at a smaller scale in AD patients suffering from impairments in executive processing, and T2DM patients may be at a higher risk of developing AD ( Redondo et al, 2016 ).…”

Section: Introductionmentioning

confidence: 99%

Increased Brain Iron Detection by Voxel-Based Quantitative Susceptibility Mapping in Type 2 Diabetes Mellitus Patients With an Executive Function Decline

Zhang²,

Zhang

et al. 2021

Front. Neurosci.

View full text Add to dashboard Cite

PurposeBrain iron accumulation has been suggested as a pathomechanism in patients with type 2 diabetes mellitus (T2DM) with cognitive impairment. This research aims to examine the total-brain pattern of iron accumulation in relation to executive function decline in patients with T2DM by voxel-based quantitative susceptibility mapping (QSM) analysis.Materials and MethodsA total of 32 patients with T2DM and 34 age- and sex-matched healthy controls (HCs) were enrolled in this study. All participants underwent brain magnetic resonance examination, and 48 individuals underwent cognitive function assessments. Imaging data were collected with three-dimensional fast low-angle shot sequences to achieve magnitude as well as phase images. Using voxel-based QSM analysis, we compared the voxel-wise susceptibility values of the whole brain among groups and explored whether the susceptibility values had correlations with cognitive data.ResultsAmong the 66 participants, cognitive function was estimated in 23 patients with T2DM (11 males and 12 females; average age, 64.65 ± 8.44 years) and 25 HCs (13 males and 12 females; average age, 61.20 ± 7.62 years). T2DM patients exhibited significantly (t = 4.288, P < 0.001) lower Montreal Cognitive Assessment (MoCA) scores [T2DM, 27 (27, 28); HCs, 29 (28, 29); normal standard ≥ 26)] and higher Trail-making Test (TMT)-A/TMT-B scores [71 (51, 100)/185 (149, 260)] than HCs [53 (36.5, 63.5)/150 (103, 172.5)] (Z = 2.612, P = 0.009; Z = 2.797, P = 0.005). Subjects with T2DM showed significantly higher susceptibility values than HCs in the caudate/putamen/pallidum, frontal inferior triangular gyrus, and precentral gyrus on the right hemisphere. In contrast (HC > T2DM), no region showed a significant difference in susceptibility values between the groups. The correlation analysis between susceptibility values and cognitive function scores was tested by voxel-based susceptibility value with sex and age as covariates. After multiple comparison correction, in T2DM patients, the left thalamus showed a significant relationship with TMT-A (R2 = 0.53, P = 0.001). The right thalamus and left thalamus showed a significant relationship with TMT-B (R2 = 0.35, P = 0.019; and R2 = 0.38, P = 0.017, respectively). In HCs, the cluster of right precentral/middle frontal gyrus/inferior frontal gyrus/inferior triangular gyrus showed a significant relationship with TMT-B (R2 = 0.59, P = 0.010). No relationship was found between the susceptibility values with MoCA in the brain region in both two groups.ConclusionPatients with T2DM presented declined cognitive assessments and elevated iron deposition in the striatum and frontal lobe, suggesting that executive function decline in T2DM might be associated with the cerebral iron burden and that changes in susceptibility values may represent a latent quantitative imaging marker for early assessment of cognitive decline in patients with T2DM.

show abstract

Section: Introductionmentioning

confidence: 99%

Increased Brain Iron Detection by Voxel-Based Quantitative Susceptibility Mapping in Type 2 Diabetes Mellitus Patients With an Executive Function Decline

Zhang²,

Zhang

et al. 2021

Front. Neurosci.

View full text Add to dashboard Cite

show abstract

“…T2DM can be used independently to measure the risk of Alzheimer's disease (AD), vascular dementia (VD), and mild cognitive impairment (MCI) [ 6 ]. Patients with T2DM show more executive dysfunction than nondiabetics [ 7 ], which is associated with mild-to-moderate executive function (EF) decrements [ 8 ]. EF declines in T2DM patients compared to healthy older controls but to an extent smaller than that suffered by AD patients; the impairment of executive processing of T2DM patients suggests that these patients are at risk of developing AD [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Increased Brain Iron Deposition in the Putamen in Patients with Type 2 Diabetes Mellitus Detected by Quantitative Susceptibility Mapping

Zhang

et al. 2020

Journal of Diabetes Research

View full text Add to dashboard Cite

Background. The underlying brain structural changes in type 2 diabetes mellitus (T2DM) patients have attracted increasing attention. The insulin-resistant state causes iron overload in neurons and leads to lesions in the central nervous system. Quantitative susceptibility mapping (QSM) can provide a noninvasive quantitative analysis of brain iron deposition. We aimed to compare the difference of brain iron deposition in the gray matter nucleus between T2DM patients and healthy elderly individuals using QSM. Methods. Thirty-two T2DM patients and thirty-two age- and gender-matched healthy controls (HCs) were enrolled in this research. Twenty-three patients and twenty-six HCs underwent cognitive assessments. Brain QSM maps were computed from multiecho GRE data using morphology-enabled dipole inversion with automatic uniform cerebrospinal fluid zero reference algorithm (MEDI+0). ITK-SNAP was used to measure the susceptibility values reflecting the content of iron in the regions of interest (ROIs). Results. The study included thirty-two T2DM patients (20 males and 12 females; mean age of 61.09±9.99 years) and 32 HCs (14 males and 18 females; mean age of 59.09±9.77 years). These participants had no significant difference in age or gender (P>0.05). Twenty-three patients with T2DM (11 males and 12 females; mean age, 64.65±8.44 years) and twenty-six HCs (14 males and 12 females; mean age, 62.30±6.13 years) received an assessment of cognitive function. T2DM patients exhibited an obviously (t=3.237, P=0.003) lower Montreal Cognitive Assessment (MoCA) score (26.78±2.35; HCs, 28.42±0.64; normal standard ≥26) and a higher Stroop color-word test (SCWT)-C score [87(65,110); HC, 63(60,76.75), Z=−2.232, P=0.003] than HCs. The mean susceptibility values in the putamen appeared obviously higher in T2DM patients than in HCs (t=−3.994, P<0.001). The susceptibility values and cognitive assessment scores showed no obvious association (P>0.05). However, an obvious correlation was observed between the changes in the susceptibility values in the putamen and the thalamus/dentate nucleus (r=0.404, P<0.001; r=0.423, P<0.001). Conclusion. T2DM patients showed increased susceptibility values in the putamen and had declines in executive functions, but the linear association between them was not statistically significant. Changes in susceptibility values in the putamen indicated increased iron deposition and might be used as a quantitative imaging marker of central nervous system injury in T2DM patients. QSM might be able to help probe micro neuronal damage in gray matter and provide information on diabetic encephalopathy.

show abstract

“…Most patients (95/107, 89%) were hospitalized for the first time to optimize their diabetes treatment and to receive diabetes education. The median hospitalization period of all patients was 10 days, and their median diabetes duration was 5 years [1,15]. In total, 23 patients (21%) had received insulin therapy.…”

Section: Characteristics Of Participantsmentioning

confidence: 99%

“…Therefore, the J-DKT would be useful to assess the efficacy of diabetes education programs for Japanese in-patients before discharge, but the effects of aging should be considered. Aging has been reported to be the best predictor of cognitive decline even in absence of dementia 15,16 .…”

mentioning

confidence: 99%

Validity and reliability of the Japanese version of the diabetes knowledge test among in‐patients with type 2 diabetes

Minami

Shirakawa

Hiiragi

et al. 2021

J of Diabetes Invest

Self Cite

View full text Add to dashboard Cite

Aims/Introduction: The diabetes knowledge test (DKT) is unavailable in Japan. In this study, we developed and evaluated a Japanese version of the DKT (J-DKT) for in-patients with type 2 diabetes before and after receiving diabetes education. Materials and Methods: The J-DKT contains 12 questions (0-12 points) to assess knowledge regarding diabetes, its complications, and diabetic nutrition therapy. During the median 10 days of hospitalization, 107 patients with type 2 diabetes received diabetes education (20 min private lessons every day from physicians, two nutrition counselling programs from dietitians, and a 2 h group session conducted by physicians, dietitians, and nurses). The J-DKT was administered on admission and before discharge. To confirm the J-DKT's reliability, we assessed the internal consistency using Cronbach's a (≥0.70 was considered acceptable). To evaluate its validity, we investigated changes in the J-DKT total scores after the education programs and examined the differences in the scores among groups classified based on patient characteristics such as age, diabetes-related hospitalization history, and hospitalization duration. Results: The J-DKT total scores increased from 5 to 8 (P ˂ 0.01) after the education programs. The J-DKT before and after the program showed a Cronbach's a of 0.48 and 0.73, respectively. Except for age, baseline characteristics such as history and period of hospitalization for diabetes were not associated with the J-DKT scores after the education program. Conclusions: The validity and reliability of the J-DKT after the diabetes education program were acceptable in this study.

show abstract

The effect of long-term past glycemic control on executive function among patients with type 2 diabetes mellitus

Cited by 12 publications

References 32 publications

Increased Brain Iron Detection by Voxel-Based Quantitative Susceptibility Mapping in Type 2 Diabetes Mellitus Patients With an Executive Function Decline

Increased Brain Iron Detection by Voxel-Based Quantitative Susceptibility Mapping in Type 2 Diabetes Mellitus Patients With an Executive Function Decline

Increased Brain Iron Deposition in the Putamen in Patients with Type 2 Diabetes Mellitus Detected by Quantitative Susceptibility Mapping

Validity and reliability of the Japanese version of the diabetes knowledge test among in‐patients with type 2 diabetes

Contact Info

Product

Resources

About