Is cognitive impairment associated with the presence and severity of peripheral neuropathy in patients with type 2 diabetes mellitus?

Diabetology & Metabolic Syndrome

Rosane Kupfer¹  Carolina Meireles¹  Bruno Cury¹  Ana Luiza Soldera¹  Rodrigo O. Moreira¹ 

[1] Instituto Estadual de Diabetes e Endocrinologia (IEDE), Pontificia Universidade Católica do Rio de Janeiro (PUC-RJ), Rua Moncorvo Filho 90, Rio de Janeiro, CEP 20211-340, RJ, Brazil

关键词: Alzheimer’s disease;    Cognition;    Diabetic neuropathy;   

Others  :  1213807
DOI  :  10.1186/s13098-015-0045-0

 received in 2015-02-19, accepted in 2015-05-21,  发布年份 2015

【 摘 要 】

Background

Peripheral Diabetic Neuropathy (PDN) and cognitive impairment are complications of Diabetes Mellitus (DM) that seem to share several underlying mechanisms. The aim of this study was to investigate whether diabetic patients would have worse cognitive function than non diabetic individuals and within diabetic patients, whether those with PDN would present an even more significant cognitive impairment.

Findings

Ninety four (94) outpatients with Type 2 DM were sequentially evaluated. Also, Fifty four (54) healthy individuals were sequentially selected to match the diabetic group. For the assessment of neuropathy, Portuguese versions of the Neuropathy Disability Score (NDS) and Neuropathy Symptom Score (NSS) were used. Global cognitive function was assessed by using the Portuguese Version of the Mini-Mental State Examination (MMSE), Trail Making Tests A and B and Verbal Fluency Test. Significantly lower scores were found in the Type 2 DM group in comparison to control group in the MMSE (25.7 [16–30] vs 27.6 [19–30]; p <0.001). Within T2DM group, forty five (45) patients were diagnosed with PDN. No differences were found between patients with and without PDN in all cognitive tests (p >0.05 in all comparison). No correlation was also found among NSS, NDS and any of the cognitive tests.

Conclusion

Although diabetic patients do have a worse cognitive function, this impairment does not seem to be related to the presence and/or severity of PDN.

【 授权许可】

   
2015 Moreira et al.

【 参考文献 】

• [1]Singh R, Kishore L, Kaur N: Diabetic peripheral neuropathy: current perspective and future directions. Pharmacol Res 2014, 80:21-35.
• [2]Bloemer J, Bhattacharya S, Amin R, Suppiramaniam V: Impaired insulin signaling and mechanisms of memory loss. Prog Mol Biol Transl Sci 2014, 121:413-49.
• [3]Moreira RO, Campos SC, Soldera AL: Type 2 Diabetes Mellitus and Alzheimer’s Disease: from physiopathology to treatment implications. Diabetes Metab Res Rev 2013.
• [4]Pohanka M: Alzheimer’s Disease and Oxidative Stress: A Review. Curr Med Chem 2013, 21(3):356-64.
• [5]Schrag M, Mueller C, Zabel M, Crofton A, Kirsch WM, Ghribi O, et al.: Oxidative stress in blood in Alzheimer’s disease and mild cognitive impairment: a meta-analysis. Neurobiol Dis 2013, 59:100-10.
• [6]Languren G, Montiel T, Julio-Amilpas A, Massieu L: Neuronal damage and cognitive impairment associated with hypoglycemia: An integrated view. Neurochem Int 2013, 63(4):331-43.
• [7]Umegaki H, Kawamura T, Umemura T, Kawano N: Factors associated with cognitive decline in older adults with type 2 diabetes mellitus during a 6-year observation. Geriatr Gerontol Int 2015, 15(3):302-10.
• [8]Imamine R, Kawamura T, Umemura T, Umegaki H, Kawano N, Hotta M, et al.: Does cerebral small vessel disease predict future decline of cognitive function in elderly people with type 2 diabetes? Diabetes Res Clin Pract 2011, 94(1):91-9.
• [9]Moreira RO, Castro AP, Papelbaum M, Appolinario JC, Ellinger VC, Coutinho WF, et al.: Translation into Portuguese and assessment of the reliability of a scale for the diagnosis of diabetic distal polyneuropathy. Arq Bras Endocrinol Metabol 2005, 49:944-50.
• [10]Young MJ, Boulton AJ, MacLeod AF, Williams DR, Sonksen PH: A multicentre study of the prevalence of diabetic peripheral neuropathy in the United Kingdom hospital clinic population. Diabetologia 1993, 36:150-4.
• [11]Lourenço RA, Veras RP: Mini-Mental State Examination: psychometric characteristics in elderly outpatients. Rev Saude Publica 2006, 40(4):712-9.
• [12]Hugenschmidt C, Williamson JD: Solving the mystery of the diabetes-dementia connection: New clues-but far from “case closed”. J Diabetes Complications 2014, 28(1):8-9.