Endocrine Abstracts

Objective: To determine the effect of glycemic variability on cognitive function in patients with type 1 diabetes mellitus.

Materials: Thirty patients with type 1 diabetes mellitus were examined at the age of 29.7 (27.45–30.4) years, the duration of the disease was 19 (15.1–20.3) years. Patients were divided into 2 groups: 1st group (n=15) – patients with cognitive impairment, 2nd group (n=15) – without.

Methods: All patients were evaluated for cognitive status using the Montreal Cognitive Scale. The content of HbA1c was determined on DS5 Glycomat (Drew Scientific, The Netherlands). For the diagnosis of fluctuations in glycemia, continuous monitoring of glycemia was conducted using the iPro-2 (Medtronic, USA) and CareLink iProTM software. EasyGV calculator (2011) was used to analyze the variability of glycemia. The following indices were studied: mean glycemic mean (MEAN), standard deviation (S.D.), mean amplitude of glycemic fluctuations (MAGE), long-term glycemic index (CONGA), glycemia lability index (LI), hypoglycemia risk index (LBGI), hyperglycemia risk index (HBGI), mean hourly rate of change in glycemia (MAG). Statistical processing of the obtained data was carried out using the application software package R-system

Results: As a result of the study, patients with type 1 diabetes of the main group were diagnosed with cognitive impairment, the mean score was 23.8±0.66, when in the control group it was 26.4±0.13 (t=3.6, P=0.001). In the study of HbA1c in blood plasma, it was determined that the mean level in the main group was 10.5±1.3%, and in the control group it was 6.7±0.23. % (t=−2.5, P=0.015). Significant difference in MEAN, S.D., CONGA, LBGI, HBGI, MAGE and MAG values between the groups is recorded. When performing the correlation analysis, it was shown that the level of HbA1c (χ2=−0.450, P=0.014), as well as the parameters of the variability of glycemia-MEAN (χ2=−0.584, P=0.001), S.D. (χ2), affects the cognitive functions in type 1 diabetes. =0.022, P=0.022), CONGA (χ2=−0.853, P=0.001), LBGI (χ2=−0.451, P=0.014), HBGI (χ2=−0.053, P=0.003), MAGE (χ2=−0.480, P=0.008), MAG (χ2=−0.573, P=0.001).

Conclusion: In patients with type 1 diabetes mellitus, hyperglycemia and hypoglycaemia, the duration of the increase in glycemia and the average fluctuation in glycemia may lead to a decrease in cognitive functions.