PMID- 37210479 OWN - NLM STAT- MEDLINE DCOM- 20230522 LR - 20230523 IS - 1471-2377 (Electronic) IS - 1471-2377 (Linking) VI - 23 IP - 1 DP - 2023 May 20 TI - Relationship between key continuous glucose monitoring-derived metrics and specific cognitive domains in patients with type 2 diabetes mellitus. PG - 200 LID - 10.1186/s12883-023-03242-2 [doi] LID - 200 AB - BACKGROUND: Continuous glucose monitoring (CGM)-derived time in range (TIR) is closely associated with micro- and macrovascular complications in type 2 diabetes mellitus (T2DM). This study was performed to investigate the relationship between key CGM-derived metrics and specific cognitive domains in patients with T2DM. METHODS: Outpatients with T2DM who were otherwise healthy were recruited for this study. A battery of neuropsychological tests was performed to evaluate cognitive function, including memory, executive functioning, visuospatial ability, attention, and language. Participants wore a blinded flash continuous glucose monitoring (FGM) system for 72 h. The key FGM-derived metrics were calculated, including TIR, time below range (TBR), time above range (TAR), glucose coefficient of variation (CV), and mean amplitude of glycemic excursions (MAGE). Furthermore, the glycemia risk index (GRI) was also calculated by the GRI formula. Binary logistic regression was used to assess risk factors for TBR, and we further analysed the associations between neuropsychological test results and key FGM-derived metrics with multiple linear regressions. RESULTS: A total of 96 outpatients with T2DM were recruited for this study, with 45.8% experiencing hypoglycemia (TBR(< 3.9 mmol/L)). Spearman analysis results revealed that a higher TBR(< 3.9 mmol/L) was correlated with worse performance on the Trail Making Test A (TMTA), Clock Drawing Test (CDT), and cued recall scores (P < 0.05). Logistic regression analysis results indicated that the TMTA (OR = 1.010, P = 0.036) and CDT (OR = 0.429, P = 0.016) scores were significant factors influencing the occurrence of TBR(< 3.9 mmol/L). Multiple linear regressions further demonstrated that TBR(< 3.9 mmol/L) (beta = -0.214, P = 0.033), TAR(> 13.9 mmol/L) (beta = -0.216, P = 0.030) and TAR(10.1-13.9 mmol/L) (beta = 0.206, P = 0.042) were significantly correlated with cued recall scores after adjusting for confounding factors. However, TIR, GRI, CV and MAGE showed no significant correlation with the results of neuropsychological tests (P > 0.05). CONCLUSIONS: A higher TBR(< 3.9 mmol/L) and TAR(> 13.9 mmol/L) were associated with worse cognitive functions (memory, visuospatial ability, and executive functioning). Conversely, a higher TAR of 10.1-13.9 mmol/L was associated with better memory performance in memory tasks. CI - (c) 2023. The Author(s). FAU - Dong, Shanshan AU - Dong S AUID- ORCID: 0000-0002-0959-8999 AD - Department of Endocrinology and Metabolism, The First Hospital of Hebei Medical University, No.89, Donggang Road, Shijiazhuang, 050031, P. R. China. FAU - Wang, Lina AU - Wang L AD - Department of Endocrinology and Metabolism, The First Hospital of Hebei Medical University, No.89, Donggang Road, Shijiazhuang, 050031, P. R. China. FAU - Zhao, Chenxu AU - Zhao C AD - Department of Endocrinology and Metabolism, The First Hospital of Hebei Medical University, No.89, Donggang Road, Shijiazhuang, 050031, P. R. China. FAU - Zhang, Rui AU - Zhang R AD - Central Laboratory, The First Hospital of Hebei Medical University, Shijiazhuang, 050031, P. R. China. AD - Hebei International Joint Research Center for Brain Science, Shijiazhuang, 050031, P. R. China. AD - Hebei Key Laboratory of Brain Science and Psychiatric-Psychologic Disease, Shijiazhuang, 050031, P. R. China. FAU - Gao, Zhaoyu AU - Gao Z AD - Central Laboratory, The First Hospital of Hebei Medical University, Shijiazhuang, 050031, P. R. China. AD - Hebei International Joint Research Center for Brain Science, Shijiazhuang, 050031, P. R. China. AD - Hebei Key Laboratory of Brain Science and Psychiatric-Psychologic Disease, Shijiazhuang, 050031, P. R. China. FAU - Jiang, Lei AU - Jiang L AD - Central Laboratory, The First Hospital of Hebei Medical University, Shijiazhuang, 050031, P. R. China. AD - Hebei International Joint Research Center for Brain Science, Shijiazhuang, 050031, P. R. China. AD - Hebei Key Laboratory of Brain Science and Psychiatric-Psychologic Disease, Shijiazhuang, 050031, P. R. China. FAU - Guo, Yingying AU - Guo Y AD - Department of Endocrinology and Metabolism, The First Hospital of Hebei Medical University, No.89, Donggang Road, Shijiazhuang, 050031, P. R. China. FAU - Zhou, Huimin AU - Zhou H AD - Department of Endocrinology and Metabolism, The First Hospital of Hebei Medical University, No.89, Donggang Road, Shijiazhuang, 050031, P. R. China. zhouhuimindoctor@163.com. AD - Hebei International Joint Research Center for Brain Science, Shijiazhuang, 050031, P. R. China. zhouhuimindoctor@163.com. AD - Hebei Key Laboratory of Brain Science and Psychiatric-Psychologic Disease, Shijiazhuang, 050031, P. R. China. zhouhuimindoctor@163.com. FAU - Xu, Shunjiang AU - Xu S AUID- ORCID: 0000-0002-9441-3900 AD - Central Laboratory, The First Hospital of Hebei Medical University, Shijiazhuang, 050031, P. R. China. xushunjiang@hebmu.edu.cn. AD - Hebei International Joint Research Center for Brain Science, Shijiazhuang, 050031, P. R. China. xushunjiang@hebmu.edu.cn. AD - Hebei Key Laboratory of Brain Science and Psychiatric-Psychologic Disease, Shijiazhuang, 050031, P. R. China. xushunjiang@hebmu.edu.cn. LA - eng GR - 20377707D/The Science and Technology project of the People's Livelihood in Hebei Province/ GR - 206Z7701G/Special Funding for Local Science and Technology Development Guided by the Central Government/ PT - Journal Article DEP - 20230520 PL - England TA - BMC Neurol JT - BMC neurology JID - 100968555 RN - 0 (Blood Glucose) RN - IY9XDZ35W2 (Glucose) SB - IM MH - Humans MH - *Diabetes Mellitus, Type 2/complications MH - Blood Glucose Self-Monitoring MH - Blood Glucose MH - Outpatients MH - Cognition MH - Glucose PMC - PMC10199495 OTO - NOTNLM OT - Cognitive impairment OT - Time above range (TAR) OT - Time below range (TBR) OT - Time in range (TIR) OT - Type 2 diabetes mellitus (T2DM) COIS- The authors declare that they have no conflicts of interest. EDAT- 2023/05/21 01:05 MHDA- 2023/05/22 06:42 PMCR- 2023/05/20 CRDT- 2023/05/20 23:13 PHST- 2022/12/08 00:00 [received] PHST- 2023/05/09 00:00 [accepted] PHST- 2023/05/22 06:42 [medline] PHST- 2023/05/21 01:05 [pubmed] PHST- 2023/05/20 23:13 [entrez] PHST- 2023/05/20 00:00 [pmc-release] AID - 10.1186/s12883-023-03242-2 [pii] AID - 3242 [pii] AID - 10.1186/s12883-023-03242-2 [doi] PST - epublish SO - BMC Neurol. 2023 May 20;23(1):200. doi: 10.1186/s12883-023-03242-2.