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Neurocognition in youth with versus without prediabetes
Youth with prediabetes exhibit cognitive impairments, including spatial working memory deficits, independent of adiposity. Early detection and treatment of impaired insulin sensitivity are crucial for preventing cognitive decline.
Area of Science:
- Neuroscience
- Endocrinology
- Metabolic Disorders
Background:
- Type 2 diabetes and prediabetes are linked to cognitive impairment in older adults.
- Mechanisms, especially in youth and independent of adiposity, remain unclear.
- The risk of cognitive impairment in youth with prediabetes due to insulin sensitivity is unknown.
Purpose of the Study:
- To investigate the relationship between prediabetes and cognition in overweight/obese youth.
- To determine if cognitive impairment is independent of adiposity.
- To explore the role of central insulin sensitivity in prediabetes-related cognitive changes.
Main Methods:
- Cross-sectional study of 69 overweight/obese youth.
- Classification into prediabetes (preT2D+) and normal glucose control (preT2D-) groups via oral glucose tolerance tests.
- Comprehensive cognitive testing, metabolic measures, and assessment of intranasal insulin effects on brain activity and connectivity.
Main Results:
- Youth with prediabetes showed significantly lower IQ and poorer performance in working memory, reaction time, and visuospatial processing compared to controls.
- Spatial working memory deficits persisted after controlling for IQ.
- Insulin sensitivity correlated negatively with processing speed and was linked to functional connectivity in brain regions involved in spatial working memory.
Conclusions:
- Prediabetes is associated with global cognitive impairment and specific spatial working memory deficits in youth, independent of adiposity.
- While central insulin sensitivity is linked to cognition, it doesn't fully explain the cognitive effects of prediabetes.
- Findings suggest early intervention for impaired insulin sensitivity is crucial in youth with prediabetes to mitigate cognitive risks.
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