Relation between cognitive capabilities and glycemic control (Hb A1c) in patients with type II diabetes mellitus: a case-control study

Abstract

Diabetes is one of the most common of chronic diseases, and via it’s common acute and chronic complications it is consideres to be a great burden on public health. Among chronic complications kidney, retin and peripheral neuron involvement can be named. Self-care in Diabetes Mellitus (DM) is crucial to avoid complications and relieve its tremendous burden. One of the complications of DM is cognitive decline, and that in turn, results in reduced self-care and poorly-controlled DM (PCDM). The objective of this study to investigate the association between cognitive capabilities and glycemic control in patients with type 2 DM. Methods: A case-control study was performed with 30 PCDM patients recognized by HbA1c levels > 8%, compared to 30 well-controlled DM patients with HbA1c levels ≤ 8%. All patients were included after filling informed consent forms. Then MoCA-B, ADL and IADL tests were performed. The association between MoCA-B scores was investigated among two diabetic groups. Odds ratio (OR) analysis was performed adjusting for age, education, and IADL scores of the patients. Also, intra- and inter-battery correlations were done among MoCA-B and IADL domains using Pearson’s r. Results: The primary results showed no crude association between MoCA-B scores in two diabetic groups (p value = 0.82). However, after adjusting for age, education, and IADL scores, it was revealed that cognitive decline in the less-educated elderly with high IADL scores has a protective effect toward poorly-controlled DM (p value < 0.0001, OR 95%CI = 0 – 0.26). In linear regression analysis among MoCA-B and IADL domains, it was demonstrated that “delayed recall” and “orientation” domains from MoCA-B, and “managing medications” and “using the phone” from IADL are associated with the levels of HbA1c (p values of <0.01, 0.043, 0.015, and 0.023, respectively). Intra- and inter-battery correlations showed a high association between MoCA’s “orientation” with IADL’s “using the phone” and “managing medications” (p values < 0.0001).