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Does Intensive Glucose Control Prevent Cognitive Decline in Diabetes? A Meta-Analysis.

Peñaherrera-Oviedo C, Moreno-Zambrano D, Palacios M, Duarte-Martinez MC, Cevallos C, Gamboa X, Jurado MB, Tamariz L, Palacio A, Santibañez R - Int J Chronic Dis (2015)

Bottom Line: Diabetes mellitus is associated with cognitive decline and impaired performance in cognitive function tests among type 1 and type 2 diabetics.Standardized mean differences (SMDs) were calculated for each domain.We found that type 1 diabetics get no cognitive benefit from a tight glucose control, whereas type 2 diabetics get some benefit on processing speed and executive domains but had worse performances in the memory and attention domains, along with a higher incidence of mortality when using intensive glucose control regimes.

View Article: PubMed Central - PubMed

Affiliation: Universidad Catolica de Santiago de Guayaquil, 090112 Guayas, Ecuador.

ABSTRACT
Diabetes mellitus is associated with cognitive decline and impaired performance in cognitive function tests among type 1 and type 2 diabetics. Even though the use of tight glucose control has been limited by a reported higher mortality, few reports have assessed the impact of treatment intensity on cognitive function. We conducted a meta-analysis to evaluate if an intensive glucose control in diabetes improves cognitive function, in comparison to standard therapy. We included 7 studies that included type 1 or type 2 diabetics and used standardized tests to evaluate various cognitive function domains. Standardized mean differences (SMDs) were calculated for each domain. We found that type 1 diabetics get no cognitive benefit from a tight glucose control, whereas type 2 diabetics get some benefit on processing speed and executive domains but had worse performances in the memory and attention domains, along with a higher incidence of mortality when using intensive glucose control regimes.

No MeSH data available.


Related in: MedlinePlus

Summary of standardized mean differences for each cognitive test, divided by type of diabetes. Results for TMT have been mirrored for a more uniform presentation.
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Related In: Results  -  Collection


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fig2: Summary of standardized mean differences for each cognitive test, divided by type of diabetes. Results for TMT have been mirrored for a more uniform presentation.

Mentions: Table 3 describes the results of each test per arm. The most commonly reported tests where the DSST, trail making, finger tap, and RAVLT. The univariate results show that on each test there is a difference between the intensive treatment group and the control group. Table 4 shows the weighted SMDs of each test stratified by type of diabetes. All tests for type 1 diabetes were nonsignificant. For type 2 diabetes the DSST SMD had a positive direction (0.71), while the Trail Making Test, Stroop test, and RAVLT had a negative direction. However, a negative direction on the SMD for Trail Making Test also favors intensive glucose control due to the nature of the test. These results are summarized in Figure 2, where results for TMT have been mirrored to a positive sense for a better presentation.


Does Intensive Glucose Control Prevent Cognitive Decline in Diabetes? A Meta-Analysis.

Peñaherrera-Oviedo C, Moreno-Zambrano D, Palacios M, Duarte-Martinez MC, Cevallos C, Gamboa X, Jurado MB, Tamariz L, Palacio A, Santibañez R - Int J Chronic Dis (2015)

Summary of standardized mean differences for each cognitive test, divided by type of diabetes. Results for TMT have been mirrored for a more uniform presentation.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4590930&req=5

fig2: Summary of standardized mean differences for each cognitive test, divided by type of diabetes. Results for TMT have been mirrored for a more uniform presentation.
Mentions: Table 3 describes the results of each test per arm. The most commonly reported tests where the DSST, trail making, finger tap, and RAVLT. The univariate results show that on each test there is a difference between the intensive treatment group and the control group. Table 4 shows the weighted SMDs of each test stratified by type of diabetes. All tests for type 1 diabetes were nonsignificant. For type 2 diabetes the DSST SMD had a positive direction (0.71), while the Trail Making Test, Stroop test, and RAVLT had a negative direction. However, a negative direction on the SMD for Trail Making Test also favors intensive glucose control due to the nature of the test. These results are summarized in Figure 2, where results for TMT have been mirrored to a positive sense for a better presentation.

Bottom Line: Diabetes mellitus is associated with cognitive decline and impaired performance in cognitive function tests among type 1 and type 2 diabetics.Standardized mean differences (SMDs) were calculated for each domain.We found that type 1 diabetics get no cognitive benefit from a tight glucose control, whereas type 2 diabetics get some benefit on processing speed and executive domains but had worse performances in the memory and attention domains, along with a higher incidence of mortality when using intensive glucose control regimes.

View Article: PubMed Central - PubMed

Affiliation: Universidad Catolica de Santiago de Guayaquil, 090112 Guayas, Ecuador.

ABSTRACT
Diabetes mellitus is associated with cognitive decline and impaired performance in cognitive function tests among type 1 and type 2 diabetics. Even though the use of tight glucose control has been limited by a reported higher mortality, few reports have assessed the impact of treatment intensity on cognitive function. We conducted a meta-analysis to evaluate if an intensive glucose control in diabetes improves cognitive function, in comparison to standard therapy. We included 7 studies that included type 1 or type 2 diabetics and used standardized tests to evaluate various cognitive function domains. Standardized mean differences (SMDs) were calculated for each domain. We found that type 1 diabetics get no cognitive benefit from a tight glucose control, whereas type 2 diabetics get some benefit on processing speed and executive domains but had worse performances in the memory and attention domains, along with a higher incidence of mortality when using intensive glucose control regimes.

No MeSH data available.


Related in: MedlinePlus