TY - JOUR
T1 - Glucose regulation, cognition, and brain MRI in type 2 diabetes
T2 - A systematic review
AU - Geijselaers, Stefan L C
AU - Sep, Simone J S
AU - Stehouwer, Coen D A
AU - Biessels, Geert Jan
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Type 2 diabetes is associated with cognitive dysfunction and structural brain changes. Abnormalities in glucose regulation are involved in several complications related to type 2 diabetes, but their role in these cerebral complications is unclear. We systematically reviewed studies of the association between glucose regulation (glycaemia, hypoglycaemic events, insulin concentration, insulin resistance, and glucose-lowering treatment) and cognitive function and brain abnormalities on MRI in people with type 2 diabetes. The 86 papers included showed that glycaemia, particularly high HbA1c concentration and glucose variability, are negatively associated with cognitive function in people with type 2 diabetes without dementia. However, the strength of this association is weak, and HbA1c generally accounted for less than 10% of the variance in cognition. Importantly, few studies have measured long-term cerebral outcomes, such as dementia and structural brain changes on MRI, and the effect of glucose-lowering treatment on these outcomes. More randomised controlled trials are needed to establish the effect of glucose-lowering treatment on long-term cognitive function in people with type 2 diabetes.
AB - Type 2 diabetes is associated with cognitive dysfunction and structural brain changes. Abnormalities in glucose regulation are involved in several complications related to type 2 diabetes, but their role in these cerebral complications is unclear. We systematically reviewed studies of the association between glucose regulation (glycaemia, hypoglycaemic events, insulin concentration, insulin resistance, and glucose-lowering treatment) and cognitive function and brain abnormalities on MRI in people with type 2 diabetes. The 86 papers included showed that glycaemia, particularly high HbA1c concentration and glucose variability, are negatively associated with cognitive function in people with type 2 diabetes without dementia. However, the strength of this association is weak, and HbA1c generally accounted for less than 10% of the variance in cognition. Importantly, few studies have measured long-term cerebral outcomes, such as dementia and structural brain changes on MRI, and the effect of glucose-lowering treatment on these outcomes. More randomised controlled trials are needed to establish the effect of glucose-lowering treatment on long-term cognitive function in people with type 2 diabetes.
UR - http://www.scopus.com/inward/record.url?scp=84927524191&partnerID=8YFLogxK
U2 - 10.1016/S2213-8587(14)70148-2
DO - 10.1016/S2213-8587(14)70148-2
M3 - Article
AN - SCOPUS:84927524191
SN - 2213-8587
VL - 3
SP - 75
EP - 89
JO - The Lancet Diabetes & Endocrinology
JF - The Lancet Diabetes & Endocrinology
IS - 1
ER -