Association of time in range with cognitive impairment in middle-aged type 2 diabetic patients

• Published in: BMC endocrine disorders Vol. 24; no. 1; pp. 241 - 9
• Main Authors: Liu, Yanting, Liu, Yanlan, Qiu, Huina, Haghbin, Nahal, Li, Jingbo, Li, Yaoshuang, Jiang, Weiran, Xia, Longfei, Wu, Fan, Lin, Chenying, Lin, Jingna, Li, Chunjun
• Format: Journal Article
• Language: English
• Published: London BioMed Central 08.11.2024; BioMed Central Ltd; BMC
• Subjects: Adult; Age; Analysis; Blood glucose; Blood Glucose - analysis; Blood glucose monitoring (BGM); Blood Glucose Self-Monitoring; Blood sugar; Blood sugar monitoring; Care and treatment; Cerebrovascular diseases; Cholesterol; Cognition disorders; Cognitive ability; Cognitive Dysfunction - epidemiology; Cognitive Dysfunction - etiology; Cognitive impairment (CI); Cross-Sectional Studies; Dementia; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - epidemiology; Diabetics; Endocrinology; Female; Glucose; Glucose monitoring; Hemoglobin; Humans; Hyperglycemia; Hypoglycemia; Male; Medicine; Medicine & Public Health; Metabolic Diseases; Middle age; Middle Aged; Neuropsychology; Prevalence; Prognosis; rology; Thyroid gland; Time Factors; Time in range (TIR); Type 2 diabetes; Type 2 diabetes mellitus (T2DM); Japan; Blood glucose monitoring (BGM); Time in range (TIR); Type 2 diabetes mellitus (T2DM); Cognitive impairment (CI)
• ISSN: 1472-6823; 1472-6823
• DOI: 10.1186/s12902-024-01772-5

Objective This study investigated the association of Time In Range (TIR) obtained from Blood Glucose Monitoring (BGM) with Cognitive Impairment (CI) inpatients with middle-aged Type 2 Diabetes Mellitus (T2DM) and further explored whether a TIR goal for T2DM in adults with > 70% possess a protective effect on cognitive function. Research design and methods A total of 274 inpatients with T2DM aged 40–64 years, who underwent seven-point BGM ( pre meals and 120 min post meals and at bedtime) were recruited in this cross-sectional study. TIR was defined as the percentage of blood glucose within the target range of 3.9-10.0mmol/L. Subjects were divided into Normal Cognitive Function (NCF) ( n  = 160) and CI ( n  = 114) groups according to the results of the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE). The association of TIR and other glycemic metrics, calculated from seven-point BGM data, with cognitive dysfunction was analyzed. Results The prevalence of CI was 41.6% in patients with middle-aged T2DM (median age 58 years). TIR was lower in CI group than in NCF group (28.6% vs. 42.9%, P  = 0.004). The prevalence of CI decreased with ascending tertiles of TIR (p for trend < 0.05). Binary logistic regression analysis showed a significant association between TIR and CI (odds ratio [OR] = 0.84, p  < 0.001) after adjusting for confounders (age, education, marital status, age at Diabetes Mellitus (DM) onset, cerebrovascular disease). Further adjustment of Standard Deviation (SD)(OR = 0.84, p  = 0.001) or Coefficient of Variation (CV)(OR = 0.83, p  < 0.001), TIR was still associated with CI. While a TIR goal of > 70% probably possessed independent protective effect on cognitive function (OR = 0.25, p  = 0.001) after controlling for confounders above. Conclusions TIR obtained from BGM was related to CI in middle-aged T2DM individuals and a TIR goal of > 70% probably possessed a protective effect on cognitive function for middle-aged T2DM .