Assessment of the Cognitive Status in Diabetes Mellitus.

Assistant Professor, Department of Physiology, PSG IMS&R. .
Journal of clinical and diagnostic research : JCDR 12/2012; 6(10):1658-1662. DOI: 10.7860/JCDR/2012/4837.2649
Source: PubMed


BACKGROUND AND OBJECTIVES: Diabetes is considered as an independent risk factor for cognitive impairment and dementia. In this study, we assessed the cognitive status of diabetics and non diabetics by the Mini Mental Status Examination (MMSE) and the Modified Mini Mental Status Examination (3MS) and also found a correlation of age, sex, the duration of diabetes and HbA1C with the cognitive status among the diabetics. MATERIALS AND METHODS: Thirty males and females above the age of 50 years, with and without diabetes, were included in the study. Both the groups underwent a cognition assessment by MMSE and 3MS and they scored 30 and 100 respectively. The correlation of age, sex, the duration of diabetes and HbA1C among the diabetics with 3MS was also done. STATISTICAL ANALYSIS: The analysis was done by using the SPSS software, version 13. The unpaired t test and one way ANOVA were used for various analyses. A p value of < 0.05 was considered to be statistically significant. RESULTS: The diabetics showed decreased MMSE and 3MS scores (p<0.001). 63.33% of the diabetics had a decreased cognition, based on the MMSE and 70% of the diabetics had a decreased cognition, based on the 3MS. The correlation of age, sex, the duration of diabetes and HbA1C among the diabetics with cognition status was not significant. CONCLUSION: Diabetes is associated with lower levels of the cognitive function. By the early implementation of MMSE, we can detect even a mild cognitive impairment, so that adequate treatment can be given, to prevent dementia.

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    • "The evidence regarding DM as a risk factor for cognitive impairment is robust; however, cognitive screening of patients with T2DM in primary care is not routine practice (Alencar et al, 2010; Shuba and Karan, 2012). Cognitive impairment in patients with T2DM is a factor associated with poor diabetes self-care, including adhering to oral and injectable medications, diet, exercise and monitoring (Rosen et al, 2003; Feil et al, 2011). "
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    ABSTRACT: Diabetes accelerates memory dysfunction in a continuous, slowly pathological process. Studies suggest that the time course of certain biomarkers can characterize the pathological course of the disease to provide information for early intervention. Thus, there is an urgent need for validated biomarkers to characterize the cognitive impairment induced by DM. We aimed to detect changes in cerebrospinal fluid biomarkers such as amyloid β42, phosphorylated tau protein, interleukin 6, and acetylcholine in diabetic rats over time, and to analyse the relationship between diabetes and cognitive impairment. Rats were injected once intraperitoneally with 1% of streptozotocin to establish a diabetic model. Index changes were investigated longitudinally and all were measured at the end of the experiment at day 75. Aβ42, P-tau, IL-6, and ACh levels in CSF, insulin levels in plasma, and Aβ42 levels in plasma and brain tissue were measured by ELISA. Compared with control, the diabetic model showed ACh in CSF to be decreased by day 15, continuing lower out to day 75. Aβ42 changes in brain and blood showed the same trends but exhibited minima at different time points: day 30 in CSF and day 15 in plasma. After the minimum, Aβ42 in cerebrospinal fluid rose and levelled off lower than in the control group, whereas Aβ42 in plasma rose and went above the controls at day 30, slowly trending upwards for the remainder of the experiment. P-tau protein in CSF in diabetic rats showed an increasing trend, becoming significantly different from the controls at day 60 and day 75. Aβ42 in CSF was strongly negatively correlated with blood glucose at day 15 and was negatively correlated with insulin in serum, particularly at day 45. Our longitudinal research model suggest that changes in the measured biomarkers appear before learning and memory impairments do. Aβ42 and ACh in the diabetes model group clearly changed from day 0 to day 45, and then P-tau and IL-6 varied significantly from day 45 to day 75. The reduced ACh levels observed possibly correlated with the factors common to changes in Aβ42, P-tau, and IL-6.
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