Correlation Analysis Of Blood Glucose Fluctuation And Cognitive Impairment Inpatients With Type 2 Diabetes

Objective: To explore the correlation between blood glucose fluctuation and cognitive impairment in patients with type 2diabetes mellitus(T2DM),providing reference for early detection,diagnosis and treatment of diabetes-related cognitive impairment.Method: A total of 83 T2 DM patients,52 males and 31 females,aged 45-75 years old,with an average age of 62.11 ± 7.474,attending the Department of Endocrinology,the First Hospital of Hebei Medical University from March 2021 to March 2022 were included in this study.All included subjects signed informed consent,which was reviewed and approved by the Ethics Committee of the First Hospital of Hebei Medical University.T2 DM patients who met the inclusion criteria were divided into cognitive dysfunction group and no cognitive dysfunction group by Mini-mental state examination(MMSE)Montreal cognitive assessment(Mo CA).(Mo CA: those with ≤ 13 points for those with0 years of education,≤ 19 points for those with less than 7 years,and ≤ 24 points for those with more than or equal to 7 years were identified as cognitive impairment),and the correlation between blood glucose fluctuations and cognitive function was analyzed in both groups.Results:1.The mean levels of time in range(TIR)in the cognitively impaired group was lower than that of the cognitively normal group,mean amplitude of glycemic excursions,standard deviation of blood glucose,fasting plasma glucose and glycosylated hemoglobin in the cognitive impairment group were higher than those in the cognitively normal group,and there were statistical differences between the two groups(P < 0.05).Binary Logistic regression analysis indicated that TIR was positively correlated with cognitive function,while fasting plasma glucose,glycosylated hemoglobin and mean blood glucose fluctuation were negatively correlated with cognitive function.2.ROC curve showed that within the target range,the area under the curve of diagnostic value of cognitive impairment such as time,mean amplitude of glycemic excursions,fasting plasma glucose and glycosylated hemoglobin were 0.801,0.633,0.714 and 0.751,respectively.3.The cognitive impairment group was lower than the cognitively normal group in the reverse-number span test,the clock drawing test,the Mini-mental state examination(MMSE),the Montreal cognitive assessment(Mo CA),the delayed recall,the cued recall,and the long delay,with statistical significance(P< 0.05).Conclusion:1.The greater the fluctuation of blood glucose in T2 DM patients,the higher the risk of cognitive impairment.2.Cognitive impairment in T2 DM patients is mainly manifested as memory and executive function impairment.