Parents matter: intergenerational influences of diabetes mellitus on glycemic control and morbidity in older type 2 diabetic males.

In a cross-sectional study, the effects of disease duration of type 2 diabetes mellitus (DM) were examined along with parent history of DM on disease-related outcome variables. Specifically, the moderating role of parent history of DM on outcome variables was examined. Participants were 53 male veterans with DM. Chart reviews and self-reports were examined. Results showed that in those with a positive parent history of DM, hopelessness increased with diabetes duration. In the negative parent history group, glycemic control worsened with disease duration. These findings suggest parent history of DM should be considered in designing interventions to facilitate coping with type 2 diabetes.

Blood glucose levels before and after cognitive testing in diabetes mellitus.

The primary indices of diabetes mellitus (DM), including hemoglobin A1c (HbA1c) and fasting glucose, appear to be only moderately predictive of the cognitive impairments exhibited by patients with DM. There is evidence that in DM the ability to utilize glucose is compromised and the authors hypothesized that this difficulty might be relevant to the study of cognitive function in DM. Thus, the authors examined the relationship between cognitive performance and changes in peripheral glucose from the start to the conclusion of cognitive testing. Individuals who showed decreased glucose levels from the start to the conclusion of cognitive testing performed significantly better than those exhibiting moderate to slight increases in glucose levels from the start to the conclusion of testing. Apparently, the putative utilization of blood glucose rather than the glucose levels prior to or following a cognitive challenge is associated with better cognitive performance primarily on more complex cognitive tests. This brief and inexpensive test of changes in glucose levels has potential clinical implications for assessing cognitive status in DM.

Light to moderate alcohol drinking is associated with higher cognitive function in males with type 2 diabetes.

This study examined cognitive function in males with type 2 diabetes who drank light to moderate levels of alcohol in comparison to abstainers. Patients who abstained from alcohol use (Abstainer; N = 99) were compared to patients who were current drinkers (Drinker; N = 20) with respect to demographic, clinical, and cognitive variables. There were no significant differences between the Drinker and Abstainer groups in demographic and general clinical variables (p values > .05). After controlling for various potential confounding variables including age, education level, number of years diagnosed with diabetes, hemoglobin A1c (HbA1c), hypertension status, and depression, multivariate analysis of covariance (MANCOVA) showed that the Drinker group performed significantly better than the Abstainer group, specifically on three of five cognitive tests - Digit Span Backward, Digit Symbol, and Trail Making B (p values < .05). Our findings suggest that light to moderate alcohol consumption, up to two drinks per day, is associated with relatively higher cognitive function in males with type 2 diabetes.

Race moderates age-related cognitive decline in type 2 diabetes.

The age-related rate of cognitive decline in patients with diabetes mellitus has received relatively little attention. In this cross-sectional study, Caucasian (N = 145) and African American (N = 25) males with diabetes mellitus were recruited to examine age-related changes in cognitive performance. It is known that African Americans with diabetes mellitus are at increased risk for more frequent and more severe diabetes-related complications. It was hypothesized that such complications may accelerate age-related cognitive decline in African Americans. Three timed tests varying in complexity assessed attention, mental flexibility, and learning. Advancing age was uniformly associated with decreasing cognitive performance but only on more complex tasks did race moderate this relationship. A steeper age-related decline was observed in African Americans on more complex cognitive tests. Diabetes may be an accelerated form of aging that impacts cognition and race appears to differentially moderate this relationship.

Improving glycemic control: the role of leisure activities and intrinsic motivation in older type 2 diabetic men.

Greater frequency of involvement with sedentary leisure activities may be associated with better disease outcomes. In this study, the frequency of engagement in sedentary leisure activities served as a construct employed to reflect the possible association between motivation and adherence with diabetic regimen. Up to a point, the higher frequency of leisure behaviors correlated with improved glycemic control and triglyceride levels in older type 2 diabetic male veterans (N = 49). Moreover, as the number of comorbidities increased, the positive association between the frequency of leisure behavior and long-term glucose control grew even stronger. Possibly, individuals with more comorbidities, who nevertheless have the resources to engage in a greater number of leisure activities, are also predisposed to adhere more effectively to medical regimen as reflected in more positive biomedical markers. Especially, those with more advanced disease-related complications benefit more from leisure activities in glycemic control.

The endocannabinoid system: a promising novel mechanistic pathway in the cardiometabolic syndrome.

The endocannabinoid system (ECS) is a neuroendocrine system that modulates several cardiometabolic processes. An overactive ECS is implicated as a significant contributor to the cardiometabolic syndrome and obesity, in addition to a large number of other physiologic processes. Endocannabinoid receptors have been detected centrally and peripherally, regulating appetite, food intake, metabolism, and storage. ECS blockade is thought to be a promising new pharmacologic modality of improving the unfavorable metabolic risk profile in patients with the cardiometabolic syndrome and obesity.