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Insulin sensitivity predicts cognitive decline in individuals with prediabetes
Caroline Willmann1,2,3, Kathrin Brockmann4,5, Robert Wagner1,2,3
1Department of Internal Medicine IV, University Hospital of Tübingen, Tübingen, Germany.
BMJ Open Diabetes Research & Care
|November 18, 2020
Summary
Insulin resistance, not just high blood sugar, predicts memory decline in prediabetes. Improving insulin sensitivity may help prevent cognitive issues in diabetes patients.
Area of Science:
- Neuroscience
- Endocrinology
- Metabolic Syndrome
Background:
- Type 2 diabetes is linked to cognitive dysfunction, even in the prediabetic stage.
- Insulin resistance is associated with impaired cognition, but longitudinal data without diabetes confounding is limited.
Purpose of the Study:
- To investigate the longitudinal predictive value of insulin resistance on cognitive function in prediabetes.
- To determine if insulin sensitivity or secretion is associated with cognitive decline.
Main Methods:
- Longitudinal analysis of 175 prediabetic participants from the 'Tübinger Evaluation of Risk Factors for Early Detection of Neurodegeneration' Study.
- Neurocognitive assessment using the CERAD Plus battery at baseline and every 2 years.
- Oral glucose tolerance tests (OGTTs) to assess insulin sensitivity and secretion.
Main Results:
- Insulin sensitivity positively correlated with cognitive function over time (p=0.0057).
- Memory domain showed a steeper decline with lower insulin sensitivity (p=0.029).
- Insulin secretion was not associated with cognitive performance.
Conclusions:
- Insulin resistance, rather than elevated blood glucose alone, predicts cognitive decline, particularly in memory, in prediabetes.
- Treatments enhancing insulin sensitivity may help prevent cognitive decline in diabetes patients.
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