The variability of glycemia in patients with type 1 diabetes mellitus: a relationship with cognitive dysfunction and the results of magnetic resonance methods

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Abstract

BACKGROUND: today the variability of glycemia is an important problem in achieving control over diabetes mellitus. Cognitive dysfunction is one of the complications of this disease. It can be assumed that the basis of cognitive impairment, as manifestations of diabetic encephalopathy, is the influence of the variability of glycemia not only on the anatomical structure, but also on the metabolic composition of the brain tissue.

AIM: to study the measures of glycemic variability, as well as their relationship with the results of neuropsychological testing and magnetic resonance methods in patients with type 1 diabetes mellitus.

MATERIALS AND METHODS: a one-stage (cross-sectional), one-center comparative study of patients with type 1 diabetes mellitus and persons without diabetes, comparable in sex and age, was conducted. All participants underwent neuropsychological testing, magnetic resonance imaging and proton magnetic resonance spectroscopy of the brain, were determined fasting plasma glucose and glycated hemoglobin. Patients with type 1 diabetes mellitus had continuous monitoring of glycemia, according to which the measures of glycemic variability were calculated. The statistical processing of the results is performed in the IBM SPSS Statistics 20.0 program.

RESULTS: 58 patients with type 1 diabetes mellitus and 20 persons without diabetes comparable in sex and age were examined, there was a decrease in scores in the performance of neuropsychological testing (p <0.05), according to the results of magnetic resonance imaging –  a decrease in the gray matter volume (p = 0.004) and an increase in white matter volume (p = 0.001), according to the proton magnetic resonance spectroscopy – a number of clinically significant changes in the metabolic composition of brain cells (p <0, 05).For patients with type 1 diabetes mellitus, the measures of glycemic variability were studied. Correlation links were found between the total result of the MoCa test and the LI (r = -0.34, p = 0.008), MODD (r = -0.36, p = 0.005) and ADRR (r = -0.28, p = 0.032).A negative relationship was found between the CONGA and hippocampal volume on the left (r = -0.27, p = 0.044). A number of correlations between the measures of glycemic variability and the content of major metabolites in different regions of the brain were also revealed (p <0.05).

CONCLUSIONS: in patients with type 1 diabetes mellitus and the presence of cognitive dysfunction, anatomical and metabolic disorders of the brain statistically associated with the variability of glycemia were revealed.

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About the authors

Iuliia G. Samoilova

Siberian State Medical University

Email: samoilova_y@inbox.ru
ORCID iD: 0000-0002-2667-4842
SPIN-code: 8644-8043

MD, PhD, Professor

Russian Federation, Россия, 634050, Томск, улица Московский тракт, д. 2

Maria A. Rotkank

Siberian State Medical University

Author for correspondence.
Email: rotkank.mariya@mail.ru
ORCID iD: 0000-0002-6921-2859
SPIN-code: 1453-1060

MD

Russian Federation, Россия, 634050, Томск, улица Московский тракт, д. 2

Natali G. Zhukova

Siberian State Medical University

Email: znatali@yandex.ru
ORCID iD: 0000-0001-6547-6622
SPIN-code: 6982-5313

MD, PhD, Professor

Russian Federation, Россия, 634050, Томск, улица Московский тракт, д. 2

Mariia V. Matveeva

Siberian State Medical University

Email: matveeva.mariia@yandex.ru
ORCID iD: 0000-0001-9966-6686
SPIN-code: 3913-5419

MD, PhD

Russian Federation, Россия, 634050, Томск, улица Московский тракт, д. 2

Ivan V. Tolmachev

Siberian State Medical University

Email: ivantolm@mail.ru
ORCID iD: 0000-0002-2888-5539
SPIN-code: 1074-1268

MD, PhD

Russian Federation, Россия, 634050, Томск, улица Московский тракт, д. 2

Dmitrii A. Kudlai

Institute for Advanced Studies of the Federal Medical and Biological Agency

Email: d62@lenta.ru
ORCID iD: 0000-0002-4212-3848
SPIN-code: 4129-7880

MD, PhD

Russian Federation, Россия, 125371, Москва, Волоколамское шоссе, д. 91

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Copyright (c) 2021 Samoilova I.G., Rotkank M.A., Zhukova N.G., Matveeva M.V., Tolmachev I.V., Kudlai D.A.

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