TY - JOUR
T1 - Consistent effects of hypoglycemia on cognitive function in people with or without diabetes
AU - Verhulst, Clementine E. M.
AU - Fabricius, Therese W.
AU - Nefs, Giesje
AU - Kessels, Roy P. C.
AU - Pouwer, Frans
AU - Teerenstra, Steven
AU - Tack, Cees J.
AU - Broadley, Melanie M.
AU - Kristensen, Peter L.
AU - McCrimmon, Rory J.
AU - Heller, Simon
AU - Evans, Mark L.
AU - Pedersen-Bjergaard, Ulrik
AU - de Galan, Bastiaan E.
N1 - This study has received funding from the Innovative Medicines Initiative 2 Joint Undertaking (which receives support from
the European Union’s Horizon 2020 research and innovation program and European Federation of Pharmaceutical Industries and Associations and T1D Exchange, JDRF, International Diabetes Federation, and The Leona M. and Harry B. Helmsley Charitable Trust) under grant agreement no. 777460.
PY - 2022/9
Y1 - 2022/9
N2 - ObjectiveHypoglycemia poses an immediate threat for cognitive function. Due to its association with acute cognitive impairment, the International Hypoglycemia Study Group (IHSG) defines a blood glucose levelResearch design and methodsAdults with type 1 diabetes with normal (n = 26) or impaired (n = 21) hypoglycemic awareness or with insulin-treated type 2 diabetes (n = 15) and age-matched control subjects without diabetes (n = 32) underwent a hyperinsulinemic-euglycemic-hypoglycemic glucose clamp (2.80 +/- 0.13 mmol/L [50.2 +/- 2.3 mg/dL]). At baseline and during hypoglycemia, calculation ability, attention, working memory and cognitive flexibility were measured with the Paced Auditory Serial Addition Test (PASAT) and the Test of Attentional Performance (TAP).ResultsFor the whole group, hypoglycemia decreased the mean +/- SD proportion of correct answers on the PASAT by 8.4 +/- 12.8%, increased reaction time on the TAP Alertness task by 32.1 +/- 66.6 ms, and increased the sum of errors and omissions on the TAP Working Memory task by 2.0 +/- 5.5 (all P < 0.001). Hypoglycemia-induced cognitive declines were largely irrespective of the presence or type of diabetes, level of symptomatic awareness, diabetes duration, or HbA(1c).ConclusionsIHSG level 2 hypoglycemia impairs cognitive function in people with and without diabetes, irrespective of type of diabetes or hypoglycemia awareness status. These findings support the cutoff value of hypoglycemia
AB - ObjectiveHypoglycemia poses an immediate threat for cognitive function. Due to its association with acute cognitive impairment, the International Hypoglycemia Study Group (IHSG) defines a blood glucose levelResearch design and methodsAdults with type 1 diabetes with normal (n = 26) or impaired (n = 21) hypoglycemic awareness or with insulin-treated type 2 diabetes (n = 15) and age-matched control subjects without diabetes (n = 32) underwent a hyperinsulinemic-euglycemic-hypoglycemic glucose clamp (2.80 +/- 0.13 mmol/L [50.2 +/- 2.3 mg/dL]). At baseline and during hypoglycemia, calculation ability, attention, working memory and cognitive flexibility were measured with the Paced Auditory Serial Addition Test (PASAT) and the Test of Attentional Performance (TAP).ResultsFor the whole group, hypoglycemia decreased the mean +/- SD proportion of correct answers on the PASAT by 8.4 +/- 12.8%, increased reaction time on the TAP Alertness task by 32.1 +/- 66.6 ms, and increased the sum of errors and omissions on the TAP Working Memory task by 2.0 +/- 5.5 (all P < 0.001). Hypoglycemia-induced cognitive declines were largely irrespective of the presence or type of diabetes, level of symptomatic awareness, diabetes duration, or HbA(1c).ConclusionsIHSG level 2 hypoglycemia impairs cognitive function in people with and without diabetes, irrespective of type of diabetes or hypoglycemia awareness status. These findings support the cutoff value of hypoglycemia
KW - IMPAIRED AWARENESS
KW - SLEEP-DEPRIVATION
KW - RECOVERY
KW - SYMPTOMS
U2 - 10.2337/dc21-2502
DO - 10.2337/dc21-2502
M3 - Article
SN - 0149-5992
VL - 45
SP - 2103
EP - 2110
JO - Diabetes Care: The Journal of Clinical and Applied Research and Education
JF - Diabetes Care: The Journal of Clinical and Applied Research and Education
IS - 9
ER -