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Area of Science:

  • Neurology
  • Endocrinology
  • Diabetology

Background:

  • Cognitive impairment is a known complication in diabetes.
  • The specific association between diabetes-related foot ulcers (DFU) and cognitive function, independent of other diabetes complications like peripheral neuropathy, remains unclear.

Purpose of the Study:

  • To investigate cognitive function in individuals with Type 2 diabetes and peripheral neuropathy.
  • To compare cognitive scores between those with active DFUs and those without DFUs.

Main Methods:

  • An age- and sex-matched, multicentre, case-control observational study.
  • 89 participants with Type 2 diabetes and peripheral neuropathy were included: 49 with DFUs (cases) and 40 without (controls).
  • Global cognition was assessed using the Montreal Cognitive Assessment (MoCA) tool.

Main Results:

  • Participants with DFUs had significantly lower global cognition scores compared to controls (median [IQR] 24.0 [21.0-25.0] vs. 26.0 [24.0-28.0]; p < 0.001).
  • Lower global cognition was independently associated with the presence of a DFU, peripheral artery disease, reduced physical activity, and no family history of diabetes (p ≤ 0.019).
  • Participants with DFUs had similar characteristics to controls, except for a lower body mass index (p = 0.028).

Conclusions:

  • The presence of a diabetes-related foot ulcer is independently associated with cognitive impairment in individuals with diabetes and peripheral neuropathy.
  • Findings suggest that DFUs, not solely other diabetes complications, contribute to cognitive decline.
  • Further research is warranted to explore causal mechanisms and develop targeted interventions for cognitive health in DFU patients.