Role of glycemic status and insulin resistance indices on cognition
Keywords:Insulin resistance, Cognition, Type 2 Diabetes mellitus
Introduction and Aim: Type 2 Diabetes Mellitus (T2DM) is presently the commonest and most prevalent disorder of metabolism which, if unmanaged, can lead to macro and micro-vascular disorders as complications. The preventive and therapeutic options for the same have been drastically improved than before and the life expectancy of the affected population has risen, but with the emergence of few other new complications like cognitive impairment and dementia. Insulin Resistance (IR) is a preclinical stage during diabetes and can potentially affect cognition. Cognition is the capability of an individual to process the given information through perception. Cognition is a broad spectrum including different cognitive domains like learning, attention, memory, language, reasoning, decision making, visuospatial skills etc., which forms the basis of intellectual development. Our present aim is to study the relationship between the glycemic profile and cognition status in diabetics.
Materials and Methods: The study population included a total of 232 subjects with the age of 40-70 years of both genders. They were recruited after obtaining the informed written consent. Fasting blood glucose, Insulin levels, HbA1C were analyzed. The insulin resistance indices such as The HOmeostasis Model of IR (HOMA-IR), QUantitative Insulin-sensitivity Check Index (QUICKI) and HOMA percent beta-cell function (HOMA-beta) were derived. Cognition status was assessed and scored using the Modified Mini Mental Status (3MS) test.
Results: HbA1c score and the 3MS score showed an association where both were negatively correlated. Insulin resistance induces too were negatively correlated with cognitive function.
Conclusion: Thus, our study suggests that unmanaged diabetes mellitus type 2 may affect the cognition. Accordingly, early diagnosis of the condition and its management is crucial to bring down the incidence of cognitive impairment, further dementia, and other neurodegenerative diseases.
Kim, B., Feldman, E.L. Insulin resistance as a key link for the increased risk of cognitive impairment in the metabolic syndrome. Exp Mol Med. 2015; 47(3):e149.
Murphy, M.P., LeVine, H. Alzheimer's disease and the amyloid-beta peptide. J Alzheimer’s Dis. 2010; 19(1):311-323.
Folstein, M.F., Folstein, S.E., McHugh, P.R. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12(3):189-198.
Ishii, M., Iadecola, C. Metabolic and non-cognitive manifestations of Alzheimer’s disease: The hypothalamus as both culprit and target of pathology. Cell Metab. 2015; 22(5):761-776.
Yaffe, K. Metabolic syndrome and cognitive decline. Curr Alzheimer Res. 2007;4(2):123-126.
Szapary, P.O., Bloedon, L.T., Samaha, F.F. Effects of pioglitazone on lipoproteins, inflammatory markers, and adipokines in nondiabetic patients with metabolic syndrome. ArteriosclerThrombVasc Biol. 2006; 26:182-188.
Evelyn Lee Teng, Helena Chang Chui; The Modified Mini-Mental State (3MS) examination. J Clin Psychiatry. 1987;48:314-318.
Luchsinger. J.A. Adiposity, hyperinsulinemia, diabetes and Al¬zheimer’s disease: an epidemiological perspective. Eur J Pharma¬col 2008; 585:119-129.
Salkovic-Petrisic, M., Hoyer, S. Central insulin resistance as a trig¬ger for sporadic Alzheimer-like pathology: An experimental ap¬proach. J Neural Transm Suppl 2007:217-233.
Apparsundaram, S., Sung, U., Price, R.D., Blakely, R.D. Trafficking-dependent and -independent pathways of neurotransmitter transporter regulation differentially involving p38 mitogen-activated protein kinase revealed in studies of insulin modulation of norepinephrine transport in SK-N-SH cells. J Pharmacol Exp Ther 2001; 299:666-677.
Liu, H., Xu, J., Qu, L. Recent study on the relationship between insulin resistance and stroke. Chin J Clin Rehabil 2003; 7:3864-3866.
Gjedde, A., Crone, C. Blood-brain glucose transfer: repression in chronic hyperglycemia. Science. 1981;214(4519):456-457.
Yaffe, K. Metabolic syndrome and cognitive disorders: is the sum greater than its parts? Alzheimer Dis Assoc Disord 2007; 21:167-171.
Zhao, W., Chen, H., Xu, H., Moore, E., Meiri, N., Quon, M.J. Brain insulin receptors and spatial memory. Correlated changes in gene expression, tyrosine phosphorylation, and signaling molecules in the hippocampus of water maze trained rats. J Biol Chem 1999; 274:34893-348902.
Fernandes, M.L., Saad, M.J., Velloso, L.A. Effects of age on elements of insulin-signaling pathway in central nervous system of rats. En¬docrine 2001;16:227-234.
Lazarov, O., Robinson, J., Tang, Y.P., Hairston, I.S., Korade-Mirnics, Z., Lee, V.M. Environmental enrichment reduces Abeta levels and amyloid deposition in transgenic mice. Cell 2005; 120:701-713.
Wu, L., Zhu, W., Pei, Y., Qu, Z., Tong, J., Zhang, T. Correlational study between cognitive function and serum cytokine concentra¬tion in senile dementia patients. Chin J Clin 2012; 6:135-138.
Gustafsson, S., Lind, L., Söderberg, S., Zilmer, M., Hulthe, J., Ingelsson, E. Oxidative stress and inflammatory markers in relation to circu¬lating levels of adiponectin. Obesity (Silver Spring) 2013; 21: 1467-1473.
Ma, L. Insulin resistance is an important risk factor for cognitive impairment in elderly patients with primary hypertension. Yonsei Med J. 2015; 56(1):89-94.
Hamed, S.A., Youssef, A,H., Elserogy, Y.E., Herdan, O., Abd-Elaal, R.F., Metwaly, N.A. Cognitive function in patients with Type 2 Di¬abetes Mellitus: Relationship to stress hormone (Cortisol). J Neu¬rol Neurosci 2013;4:3.
Cherbuin, N., Anstey, K.J. The Mediterranean diet is not related to cognitive change in a large prospective investigation: the PATH Through Life study. Am J Geriatr Psychiatry. 2011;20(7):635-639.
De Felice, F.G., Lourenco, M.V. Brain metabolic stress and neuroinflammation at the basis of cognitive impairment in Alzheimer's disease. Front Aging Neurosci. 2015;7:94.
Mari, A., Ahrén, B., Pacini, G. Assessment of insulin secretion in relation to insulin resistance. CurrOpin Clin NutrMetab Care. 2005; 8(5):529-533.
Bingham, E.M., Hopkins, D., Smith, D., Pernet, A., Hallett, W., Reed, L., et al., The role of insulin in human brain glucose metabolism: an 18fluoro-deoxyglucose positron emission tomography study. Diabetes. 2002;51(12):3384-3390.
How to Cite
Copyright (c) 2023 Biomedicine
This work is licensed under a Creative Commons Attribution 4.0 International License.