ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2019) 63 P961 | DOI: 10.1530/endoabs.63.P961

The prevalence of impaired cognitive function and depression in patients with type 2 diabetes mellitus and severe insulin resistance

Diana Šimonienę1,2 & Džilda Veličkienę1,2,3

1Hospital of Lithuanian University of Health Sciences, Department of Endocrinology, Kaunas, Lithuania, Kaunas, Lithuania; 2Lithuanian University of Health Sciences (LUHS), Department of Endocrinology, Kaunas, Lithuania. 3LUHS, Institute of Endocrinology,, Kaunas, Lithuania.

Aims were: 1. To evaluate the prevalence of impaired cognitive functions and depression in patients with type 2 diabetes mellitus (T2DM) and compare between groups.

2. To evaluate the association of cognitive functions and depression with age, gender, BMI, insulin dose, marital status and education in patients with T2DM.

Methods: Case-control study of T2DM where patients with high insulin doses (>1U/kg/24 hrs) and uncontrolled diabetes (HbA1c >9%) referred as severe insulin resistance (IR) group (case group). T2DM patients with insulin doses less than 1 U/kg/24hrs and HbA1c <8%, matched by gender, age and diabetes duration – referred as control group. Participants filled questionnaires about T2DM, duration, education, marital status. All participants with T2DM were evaluated for cognitive function with Montreal Cognitive Assessment (MOCA) questionnaire. Mental health (depression, dystymhia) was evaluated by Mini-International Neuropsychiatric Interview (MINI).

Results: 45 participants with T2DM and severe IR (case group) and 17 participants in control group were included to the study. The prevalence of impaired cognitive function in diabetic patients was 82.2% (in both groups the same prevalence), depression in 30% of patients (in severe IR group −33% and control group −23%). There was no significant differences of impaired cognitive functions and depression between groups. In the study higher frequency of single (P=0.02), more obese (P=0.02) and worse HbA1c (P=0.013) women were found, especially this tendency was noticed in patients with severe IR. Depression and dysthymia frequency was significantly higher in married patients than single, especially this association was noticed ir patients with T2DM and severe IR. Age was related with impaired cognitive function, BMI and insulin dose. There were a negative correlations: older patients with diabetes had lower MOCA results, lower BMI and used lower insulin dose.

Conclusions: 1. Impaired cognitive functions were observed for the majority of patients with type 2 diabetes, one – third of patients had depression, but it did not differ between patients with severe IR and control group.

2. Women with severe IR were more obese and had worse diabetes control than men with severe IR.

3. Married diabetic patients, especially with severe IR, more often had depression than single T2D patients with usual IR.

4. Age had a negative impact on cognitive functions in patients with T2DM. But older patients with T2DM were leaner and less IR (used lower insulin dose).

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