Endocrine Abstracts

Introduction: Hyperglycemia is a common disorder in elderly patients. Diabetes management in this population requires evaluation of medical, pharmacological and functional domains. Screening for diabetes chronic complications should include, in addition to traditional micro- and macrovascular disease, search for cognitive impairment and vitamin B12 deficiency.

Objective: To evaluate the prevalence of cognitive impairment, depression, and associated clinical variables in a population of adult patients with type 2 diabetes.

Methods: Individuals over 50 years and with type 2 diabetes, assisted at the Federal University of Pelotas, South of Brazil, were included in the study. We performed a cross-sectional study with application of a face-to-face questionnaire and evaluation of outpatient clinical records for clinical and demographic variables analysis. We use Mini-Mental State Examination (MMSE) to assess cognitive impairment, and Patient Health Questionnaire-2 (PHQ) and PHQ-9 to evaluate depression.

Results: We included 116 patients, with a median age of 62 years, 68.1% were women, 76.7% have white skin color, and 81% have 8 years of study or less. The mean A1c was 9.6%. Over 70% of the patients have at least one microvascular complication, and 52.6% have clinical macrovascular disease. The prevalence of cognitive dysfunction was 35.3% and that of depression was 33.6%. The group of patients with cognitive dysfunction has higher rates of B12 deficiency (60% vs 36.6% in controls; P = 0.01) and of benzodiazepine use (51.3% vs 30.6% in controls; P = 0.03). The presence of microvascular complications was also higher in the group of patients with cognitive dysfunction (85.4% vs 66.7% in controls, P = 0.003). Other clinical variables were not different between groups. B12 deficiency was associated with cognitive impairment even after adjustments [1.78 (1.07–2.98)]; while the association with benzodiazepine use was not significant after statistical adjustments [1.58 (0.95–2.64)].

Discussion: Patients over 50 years and with type 2 diabetes have a high prevalence of cognitive dysfunction and depression, and B12 deficiency was associated with cognitive impairment. Therefore, we strongly suggest that clinical doctors actively search for these comorbidities.