scholarly journals Does Intensive Glucose Control Prevent Cognitive Decline in Diabetes? A Meta-Analysis

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Carlos Peñaherrera-Oviedo ◽  
Daniel Moreno-Zambrano ◽  
Michael Palacios ◽  
María Carolina Duarte-Martinez ◽  
Carlos Cevallos ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Cognitive Decline ◽  
Glucose Control ◽  
Meta Analysis ◽  
Tight Glucose Control ◽  
Intensive Glucose Control ◽  
Type 2 Diabetics ◽  
The Impact

Diabetes mellitus is associated with cognitive decline and impaired performance in cognitive function tests among type 1 and type 2 diabetics. Even though the use of tight glucose control has been limited by a reported higher mortality, few reports have assessed the impact of treatment intensity on cognitive function. We conducted a meta-analysis to evaluate if an intensive glucose control in diabetes improves cognitive function, in comparison to standard therapy. We included 7 studies that included type 1 or type 2 diabetics and used standardized tests to evaluate various cognitive function domains. Standardized mean differences (SMDs) were calculated for each domain. We found that type 1 diabetics get no cognitive benefit from a tight glucose control, whereas type 2 diabetics get some benefit on processing speed and executive domains but had worse performances in the memory and attention domains, along with a higher incidence of mortality when using intensive glucose control regimes.

Abstract 17058: Does Intensive Glucose Control Prevent Cognitive Decline in Diabetes? a Meta-analysis

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Carlos A Peñaherrera Oviedo ◽  
María C Duarte Martinez ◽  
Daniel A Moreno Zambrano ◽  
Michael Palacios Mendoza ◽  
María B Jurado ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cognitive Decline ◽  
Median Duration ◽  
Glucose Control ◽  
Meta Analysis ◽  
Cognitive Test ◽  
Intensive Glucose Control ◽  
Duration Of Diabetes ◽  
Patients With Diabetes

Background: Long term diabetes is associated with cognitive decline. Blood glucose control improves outcomes in patients with diabetes, it is unclear if intensive glucose control prevents cognitive decline. The aim of this study is to conduct a meta-analysis to determine the effects of intensive glucose control on cognitive decline in patients with diabetes. Methods: We searched the MEDLINE database (1966 to December 2013) and supplemented the search with manual searches of bibliographies of key relevant articles. Keywords used for the search were: diabetes mellitus, cognitive decline, cognitive function, cognitive impairment, and glucose control. We selected all randomized studies where a measurement of cognitive decline and the level of glucose control were reported in patients with diabetes. We calculated the weighted standardized mean difference (SMD) of the measurement of cognitive decline between the intensive and standard glucose control arm. We also conducted meta-regression to evaluate the effect of the type of diabetes had on the results and stratified the analysis by type of diabetes. Results: The search strategy yielded 260 studies, of which only 7 met our eligibility criteria. Only three studies included subjects with type 2 diabetes, patients with type 2 diabetes had a median age of 62(59-63), 48(42-60) were female, the median HbA1c was 8% and the median duration of diabetes was 9 years. We included four studies with type 1 diabetes with a median age of 27(16-29) years, 49(49-50) % were female, the median Hba1c was 9% and the median duration of diabetes was 6(5-18) years. The weighted SMD of each cognitive test is shown in Table 1. Conclusions: Intensive glucose control prevents cognitive decline. The largest improvements were seen in the memory and speed processing domains. This was seen mostly in middle-aged type 2 diabetics with diabetes for 9 years and slightly out of control HbA1c.

Adverse effects of ADT on cognitive function and dementia for men with prostate cancer: A meta-analysis and systematic review.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 150-150 ◽  
Author(s):  
Maxine Sun ◽  
Alexander Cole ◽  
Nawar Hanna ◽  
Adam S. Kibel ◽  
Toni K. Choueiri ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
English Language ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Cochrane Library ◽  
Significant Heterogeneity ◽  
The Impact

150 Background: Nearly 50% of men diagnosed with prostate cancer may receive treatment with some form of androgen deprivation therapy (ADT). While some side effects of ADT are well acknowledged, the specific impact of ADT on cognitive function is uncertain. Our objective was to perform a systematic review and meta-analysis assessing the impact of ADT on overall cognitive decline, and the risks of Alzheimers, Parkinson’s disease. Methods: Relevant studies were identified through search of English language articles indexed in PubMed Medline, PsycINFO, Cochrane Library and Web of Knowledge/Science. First, we assessed rates of cognitive decline in five cohorts from three studies. Second, we assessed rates of Alzheimer’s or Parkinson disease using three large retrospective studies. A pooled-analysis was conducted using a meta-analysis. Weighted averages were reported as odds ratios (OR) with 95% confidence intervals (CI) using RevMan and a DerSimonian and Laird random-effects model. The heterogeneity test was measured using the Q-Mantel-Haenszel ( P< 0.10 was considered of significant heterogeneity). Results: With respect to overall cognitive decline (defined as scoring 1.5 standard deviations [SD] in two or more objective cognitive tests), patients receiving ADT had higher odds of overall cognitive decline than patients with prostate cancer not treated with ADT or health controls (OR: 2.03, 95% CI: 1.42–2.90). Furthermore, men with a history of ADT for prostate cancer had higher odds of developing Alzheimer’s and Parkinson dementia compared to men with prostate cancer not treated with ADT (OR: 1.32, 95% CI: 1.27–1.37). Conclusions: Men receiving ADT for prostate cancer performed significantly worse on measures of overall cognitive function. Additionally, results from the three large observational trials included suggest men exposed to ADT for prostate cancer have higher rates of Parkinson/Alzheimer’s compared to men without ADT.

scholarly journals Association and biomarker potential of elevated serum adiponectin with nephropathy among type 1 and type 2 diabetics: A meta-analysis

PLoS ONE ◽  
2018 ◽  
Vol 13 (12) ◽  
pp. e0208905 ◽  
Author(s):  
Noel Pabalan ◽  
Raphael Enrique Tiongco ◽  
Jefferyl Kae Pandac ◽  
Noemi Anne Paragas ◽  
Shamar Lo Lasta ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Elevated Serum ◽  
Serum Adiponectin ◽  
Type 2 Diabetics

scholarly journals The Impact of Frailty on the Effectiveness and Safety of Intensive Glucose Control and Blood Pressure-Lowering Therapy for People With Type 2 Diabetes: Results From the ADVANCE Trial

2021 ◽  
Author(s):  
Tu N Nguyen ◽  
Katie Harris ◽  
Mark Woodward ◽  
John Chalmers ◽  
Mark Cooper ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Glucose Control ◽  
Severe Hypoglycaemia ◽  
Intensive Glucose Control ◽  
Vascular Events ◽  
Significant Difference ◽  
Secondary Outcomes ◽  
The Impact

<b>Objective. </b>To develop a frailty index (FI) and explore the relationship of frailty to subsequent adverse outcomes on the effectiveness and safety of more intensive control of both blood glucose and blood pressure (BP), amongst participants with type-2 diabetes in the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial. <p><b>Research Design and Methods. </b>Cox proportional-hazard models were used to estimate the effectiveness and safety of intensive glucose control and BP intervention according to frailty (defined as FI>0.21) status. The primary outcomes were macrovascular events and microvascular events. The secondary outcomes were all-cause mortality, cardiovascular mortality, severe hypoglycaemia, and discontinuation of BP treatment due to hypotension/dizziness.</p> <p><b>Results.</b> There were 11140 participants (mean age 65.8, 42.5% female, 25.7% frail). Frailty was an independent predictor of all primary outcomes and secondary outcomes. The effect of intensive glucose treatment on primary outcomes showed some evidence of attenuation in the frail: HRs for combined major macro- and micro-vascular events 1.03, 95%CI 0.90-1.19 in the frail vs 0.84, 95%CI 0.74-0.94 non-frail (p=0.02). A similar trend was observed with BP intervention. <a>Severe hypoglycaemia rates (per 1000 person-years) were higher in the frail: 8.39 (6.15–10.63) vs. 4.80 (3.84–5.76) in non-frail</a> (p<0.001). There was no significant difference in discontinuation of BP treatment between frailty groups.</p> <p><b>Conclusions. </b>It was possible to retrospectively estimate frailty in a trial population, and this FI identified those at higher risk of poor outcomes. Participants with frailty had some attenuation of benefit from intensive glucose lowering and BP lowering treatments. </p>

Sign in / Sign up

Export Citation Format

Share Document