The relationship between mean amplitude of glycemic excursions and cognitive impairment in elderly patients with type 2 diabetes / 中华老年医学杂志

ABSTRACT

Objective To investigate the relationship between mean amplitude of glycemic excursions (MAGE) and cognitive impairment in elderly patients with type 2 diabetes.Methods Totally 80 patients (aged ＞ 60 years) with type 2 diabetic were selected.According to the Montreal Cognitive Assessment (MoCA) score,the patients were divided into two groups:cognitive impairment group (31cases) and non-cognitive impairment group (49 cases).Then all subjects were observed by continuous glucose monitoring for 3 days including the mean blood glucose (MBG) and its standard deviation (SD),MAGE and numbers of glycemic excursion (NGE).Results Compared with noncognitive impairment group,diabetic course,fasting blood glucose,2 h postprandial glycemia,glycosylated hemoglobin (HbA1c) and body mass index (BMI) were significantly different with the cognitive impairment group (P＜0.05).Furthermore,MAGE,MBG and SD were obviously higher than those in the non-cognitive impairment group [(5.89 ± 2.17) mmol/L vs.(3.15 ± 0.60) mmol/L,t＝8.37,P＝0.00; (11.85±3.45) mmol/L vs.(8.23±1.73)mmol/L,t＝6.23,P＝0.00; (3.16±1.29)mmol/L vs.(1.26±0.42)mmol/L,t＝9.57,P＝0.00].MoCA scores of patients with type 2 diabetes were negatively correlated with MAGE (r ＝-0.891,P ＜ 0.01).After multiple linear regression analysis,diabetic course,2 h postprandial glycemia,MAGE and SD remained independently associated with cognitive impairment in type 2 diabetic patients (R2 ＝0.835,P＜0.05)Conclusions MAGE during a daily period is associated with cognitive impairment independent of fasting blood glucose,postprandial glycemia and HbA1c.