Endocrine Abstracts

JOINT901

Introduction: People with Diabetes Mellitus (DM) often face episodes of hypoglycemia with a serious impact on their daily life. Newer data suggests that severe episodes of hypoglycemia, experienced either recently or throughout life, cause cognitive decline.

Aim: To investigate the relationship between hypoglycemic episodes and cognitive functions among people with DM.

Material – Methods: A quantitative non-randomized cross-sectional study was performed with a sample of 104 individuals with type 1 and type 2 DM aged between 18 and 65 years. Subjects included were experiencing episodes of hypoglycemia and had not been diagnosed with any disease causing cognitive impairment. The study was conducted in two public hospitals of Athens within one year. A demographic questionnaire, the Hypoglycemia Patient Questionnaire and the Clarke’s Hypoglycemia Awareness Questionnaire were administered while the Montreal Cognitive Assessment (MoCA) was also conducted. For the statistical analysis of the data, the t-test criterion for independent samples, the analysis of variance for one factor (One-way ANOVA) and the multiple regression analysis were applied.

Results: At the MoCA test the mean score was 26.16±2.69 while the lowest score was 18 and the highest was 30. More than half of the participants had a normal score (equal to or higher than 26) (59.6%) while the 40.4% presented possible mental impairment. Participants who showed reduced awareness of hypoglycemia had a lower MoCA test score than those with high awareness to a statistically significant degree (P = 0.01). A statistically significant main effect of severe hypoglycemic episodes on cognitive function score was observed (P = 0.002). Participants who had never experienced severe episodes of hypoglycemia scored higher on cognitive function than those who reported more than one severe episode (P = 0.03) with a high effect rate (d=0.82). Multiple regression analysis showed that the occurrence of a severe hypoglycemic episode 2 to 12 times (b=-0.15, P<0.05) and age (b=-0.31, P<0.001) were negative predictors of the score of the cognitive assessment.

Conclusions: Severe episodes of hypoglycemia were associated with cognitive decline in people with DM. Age was also a predictor of cognitive deficit. Further research studies are needed to clarify the relationship between hypoglycemia and cognitive function in order to improve the quality of life of people with DM.

Key words: Diabetes Mellitus, hypoglycemia, cognitive function