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Experimental non-severe hypoglycaemia substantially impairs cognitive function in type 2 diabetes: a randomised
Malin Nilsson1, Nicole Jensen2, Michael Gejl3
1Department of Endocrinology, Bispebjerg University Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark. malin.sofia.desiree.nilsson@regionh.dk.
Diabetologia
|August 2, 2019
Summary
Non-severe hypoglycemia significantly impairs cognitive function in individuals with type 2 diabetes. This study shows even mild glucose drops negatively affect memory, attention, and psychomotor speed.
Area of Science:
- Endocrinology
- Neuroscience
- Metabolic Disorders
Background:
- Hypoglycemia is a common complication in diabetes management.
- Previous research indicates a link between cognitive impairment and low blood glucose levels.
Purpose of the Study:
- To investigate the impact of non-severe insulin-induced hypoglycemia on cognitive function in type 2 diabetes patients.
- To determine if mild hypoglycemia affects specific cognitive domains like psychomotor speed and global cognition.
Main Methods:
- A randomized crossover study involving 25 participants with type 2 diabetes.
- Hyperinsulinemic glucose clamping was used to induce controlled hypoglycemic (3.0 ± 0.2 mmol/l) and euglycemic (6.0 ± 0.2 mmol/l) conditions.
- Cognitive function was assessed using a neurocognitive test battery, with psychomotor speed as the primary outcome.
Main Results:
- Hypoglycemia significantly impaired psychomotor speed (Symbol Digit Modalities Test), with a mean score difference of -7.9 points (p < 0.0001).
- Global cognitive scores were also reduced by -0.7 points (p < 0.0001) during hypoglycemia.
- Stable glucose levels were maintained, and factors like age, sex, and counter-regulatory hormones did not influence the cognitive effects.
Conclusions:
- Acute, non-severe hypoglycemia (mean plasma glucose 3.1 mmol/l) substantially impairs cognitive function in individuals with type 2 diabetes.
- These findings highlight the importance of maintaining stable glucose levels to preserve cognitive performance in this population.
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