Relationship between glycemic variability and cognitive function in lacune patients with type 2 diabetes

Area of Science:

• Neurology
• Endocrinology
• Medical Imaging

Background:

• Lacunes, resulting from lacunar infarction, can lead to disability or dementia.
• The interplay between lacune burden, cognitive function, and blood glucose fluctuations in type 2 diabetes mellitus (T2DM) patients with lacunes requires further elucidation.

Purpose of the Study:

• To investigate the association between glucose variability, lacune burden, and cognitive function in T2DM patients presenting with lacunes.

Main Methods:

• Retrospective analysis of clinical and imaging data from 144 T2DM patients with lacunes.
• 72-hour continuous glucose monitoring (CGM) for glucose variability assessment.
• Montreal Cognitive Assessment (MoCA) for cognitive function evaluation.
• MRI for lacune burden assessment.
• Logistic regression, ROC curves, and nomogram for risk prediction.

Main Results:

• Elevated glucose variability (higher SD and %CV) and lower time in range (TIR) were associated with increased lacune burden.
• Higher SD and %CV, and lower TIR were significant risk factors for cognitive impairment.
• A predictive nomogram model for cognitive impairment demonstrated clinical utility.

Conclusions:

• Blood glucose variability is a critical factor influencing lacune burden and cognitive dysfunction in T2DM patients with lacunes.
• %CV and TIR show predictive value for cognitive impairment in these patients.