Key result
Young adults with early-stage type 2 diabetes exhibited a 1.5% greater incremental rate in global cognitive scores (MoCA) and a significant normalization of baseline brain hyperconnectivity over 18 months compared to healthy controls.
Why the study?
Following findings of adaptive hyper-connectivity in young type 2 diabetes with cognitive decrements, this study aimed to explore changes in functional connectivity and cognitive outcomes after regular glycemic control.
Does regular glycemic control improve cognitive function and normalize brain functional connectivity in young adults with type 2 diabetes?
Cohort (n=50)
No
Does regular glycemic control improve cognitive function and normalize brain functional connectivity in young adults with type 2 diabetes?
Effect estimate: β = 0.015 (95% CI 0.00013-0.030)
p-value: p=0.048
Glycemic control may reverse early adaptive hyper-connectivity and cognitive decrements in young T2DM; leaves open confirmation in randomized trials.
Background: Cognitive dysfunction is an important comorbidity of diabetes characterized by brain functional hypo-connectivity. However, our recent study demonstrated an adaptive hyper-connectivity in young type 2 diabetes with cognitive decrements. This longitudinal study aimed to further explore the changes in functional connectivity and cognitive outcomes after regular glycemic control. Methods: At 18 months after recruitment, participants underwent a second cognitive assessment and magnetic resonance imaging. Three enhanced functional connectivities previously identified at baseline were followed up. Linear mixed-effects models were performed to compare the longitudinal changes of cognition and functional connectivity in patients with type 2 diabetes and non-diabetic controls. A linear regression model was used to investigate the association between changes in functional connectivity and changes in cognitive performance. Results: Improvements in multiple cognitive domains were observed in diabetes; however, the enhanced functional connectivity at baseline decreased significantly. Moreover, the decrease in hippocampal connectivity was correlated with an increase in the accuracy of Stroop task and the decrease in posterior cingulate cortex connectivity was correlated with an increase in Montreal Cognitive Assessment in diabetes. Conclusion: This study suggests diabetes-related cognitive dysfunction is not a one-way process and the early-stage enhancement of brain connectivity was a potential "window period" for cognitive reversal.
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Fang et al. (2022) conducted a cohort in Type 2 diabetes (n=50). Type 2 diabetes with regular glycemic control vs. Non-diabetic controls was evaluated on Longitudinal change in global cognitive function (log-transformed Montreal Cognitive Assessment [MoCA] score) (β = 0.015, 95% CI 0.00013-0.030, p=0.048). Young adults with early-stage type 2 diabetes exhibited a 1.5% greater incremental rate in global cognitive scores (MoCA) and a significant normalization of baseline brain hyperconnectivity over 18 months compared to healthy controls.
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