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Postprandial plasma glucose excursions and cognitive functioning in aged type 2 diabetics
A M Abbatecola1, M R Rizzo, M Barbieri
1Department of Geriatric Medicine and Metabolic Diseases, Second University of Naples, Naples, Italy.
Neurology
|July 26, 2006
Summary
High postprandial glucose excursions in older adults with type 2 diabetes are linked to cognitive decline. Tighter glucose control may help preserve cognitive function in this population.
Area of Science:
- Gerontology
- Endocrinology
- Neuroscience
Background:
- Postprandial plasma glucose (PPG) excursion significantly impacts metabolic control and diabetic complication risk.
- Older adults with type 2 diabetes mellitus (DM2) often exhibit cognitive deficits and brain changes.
- Poor metabolic control is implicated in tissue and organ damage in diabetic patients.
Purpose of the Study:
- To investigate the association between PPG excursion and cognitive decline in older adults with DM2.
- To determine if tighter PPG control can prevent cognitive decline.
Main Methods:
- Randomized controlled trial involving aged diabetic patients treated with either repaglinide (n=77) or glibenclamide (n=79).
- Assessment of cognitive functioning using Mini-Mental State Examination (MMSE) and a composite executive/attention score.
- Analysis of PPG variability (CV-PPG), hemoglobin A1c (HbA1c), and fasting plasma glucose (FPG).
Main Results:
- CV-PPG was significantly associated with lower MMSE and executive/attention functioning scores (p < 0.001).
- The repaglinide group showed a significant reduction in CV-PPG over time, unlike the glibenclamide group.
- Cognitive decline was observed in the glibenclamide group but not after adjusting for CV-PPG, suggesting PPG excursions were the driver.
Conclusions:
- Exaggerated PPG excursions are linked to impaired global, executive, and attention cognitive functions in older diabetic individuals.
- Tighter control of PPG excursions may be a strategy to prevent cognitive decline in this demographic.
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