Abstract
This article covers the study of cognitive processes in patients with type 1 and type 2 diabetes mellitus (DM) with disease duration of < 6 years, 6–10 years and > 10 years. In this study a modified analog of the d2 Test—“Clocks Carrousel” Test and SF-36 questionnaire for a self-assessment of quality of life were used. A mild cognitive impairment, namely, decrease in the level of voluntary attention, and a reduced quality of life were found in patients with type 1 and type 2 DM. It was shown that the duration of the disease affects the cognitive processes in DM patients. However, the changes differ in nature depending on the type of diabetes. In patients with T1DM the stability and some improvement of attention characteristics was observed with an increase in disease duration. The revealed changes in attention characteristics in patients with T2DM indicated some decrease in the level of voluntary attention with an increase in disease duration. The comparative analysis showed that the patients with T1DM had a lower level of attention compared with patients with T2DM. These differences were more expressed in patients with disease duration of < 6 years. The SF-36 test results revealed the same tendency of changes in mental status of the patients with DM depending on type and disease duration as changes in the characteristics of voluntary attention.
Similar content being viewed by others
REFERENCES
International Diabetes Federation. IDF Diabetes Atlas, 10th edn. Brussels, Belgium: 2021. Available at: https://www.diabetesatlas.org
American Diabetes Association (2014) Diagnosis and classification of diabetes mellitus. Diabetes Care. 37 (Suppl 1):S81–90. https://doi.org/10.2337/dc14-S081
Leung WK, Gao L, Siu PM, Lai CW (2016) Diabetic nephropathy and endothelial dysfunction: Current and future therapies, and emerging of vascular imaging for preclinical renal-kinetic study. Life Sci 166:121–130. https://doi.org/10.1016/j.lfs.2016.10.015
Cole JB, Florez JC (2020) Genetics of diabetes mellitus and diabetes complications. Nat Rev Nephrol 16(7):377–390. https://doi.org/10.1038/s41581-020-0278-5
Kawamura T, Umemura T, Hotta N (2012) Cognitive impairment in diabetic patients: Can diabetic control prevent cognitive decline? J Diabetes Investig 3(5):413–423. https://doi.org/10.1111/j.2040-1124.2012.00234.x
Hamed SA (2017) Brain injury with diabetes mellitus: evidence, mechanisms and treatment implications. Expert Rev Clin Pharmacol 10(4):409–428. https://doi.org/10.1080/17512433.2017.1293521
Zhou J, Zhang Z, Zhou H, Qian G (2020) Diabetic Cognitive Dysfunction: From Bench to Clinic. Curr Med Chem 27(19):3151–3167. https://doi.org/10.2174/1871530319666190206225635
Moran C, Münch G, Forbes JM, Beare R, Blizzard L, Venn AJ, Phan TG, Chen J, Srikanth V (2015) Type 2 diabetes, skin autofluorescence, and brain atrophy. Diabetes 64(1):279–283. https://doi.org/10.2337/db14-0506
Saedi E, Gheini MR, Faiz F, Arami MA (2016) Diabetes mellitus and cognitive impairments. World J Diabetes 17:412–422. https://doi.org/10.4239/wjd.v7.i17.412
Shalimova A, Graff B, Gąsecki D, Wolf J, Sabisz A, Szurowska E, Jodzio K, Narkiewicz K (2019) Cognitive Dysfunction in Type 1 Diabetes Mellitus. J Clin Endocrinol Metab 104(6):2239–2249. https://doi.org/10.1210/jc.2018-01315
Tamura Y, Araki A (2015) Diabetes mellitus and white matter hyperintensity. Geriatr Gerontol Int 15 (Suppl 1):34–42. https://doi.org/10.1111/ggi.12666
Musen G, Jacobson AM, Bolo NR, Simonson DC, Shenton ME, McCartney RL, Flores VL, Hoogenboom WS (2012) Resting-state brain functional connectivity is altered in type 2 diabetes. Diabetes 61(9):2375–2379. https://doi.org/10.2337/db11-1669
Lee JH, Choi Y, Jun C, Hong YS, Cho HB, Kim JE, Lyoo IK (2014) Neurocognitive changes and their neural correlates in patients with type 2 diabetes mellitus. Endocrinol Metab (Seoul) 29(2):112–121. https://doi.org/10.3803/EnM.2014.29.2.112
Zhang H, Hao Y, Manor B, Novak P, Milberg W, Zhang J, Fang J, Novak V (2015) Intranasal insulin enhanced resting-state functional connectivity of hippocampal regions in type 2 diabetes. Diabetes 64(3):1025–1034. https://doi.org/10.2337/db14-1000
Yang SQ, Xu ZP, Xiong Y, Zhan YF, Guo LY, Zhang S, Jiang RF, Yao YH, Qin YY, Wang JZ, Liu Y, Zhu WZ (2016) Altered Intranetwork and Internetwork Functional Connectivity in Type 2 Diabetes Mellitus With and Without Cognitive Impairment. Sci Rep 6:32980. https://doi.org/10.1038/srep32980
Luchsinger JA, Reitz C, Patel B, Tang MX, Manly JJ, Mayeux R (2007) Relation of diabetes to mild cognitive impairment. Arch Neurol 64(4):570–575. https://doi.org/10.1001/archneur.64.4.570
Roberts RO, Geda YE, Knopman DS, Christianson TJ, Pankratz VS, Boeve BF, Vella A, Rocca WA, Petersen RC (2008) Association of duration and severity of diabetes mellitus with mild cognitive impairment. Arch Neurol 65(8):1066–1073. https://doi.org/10.1001/archneur.65.8.1066
Musen G, Tinsley LJ, Marcinkowski KA, Pober D, Sun JK, Khatri M, Huynh R, Lu A, King GL, Keenan HA (2018) Cognitive Function Deficits Associated With Long-Duration Type 1 Diabetes and Vascular Complications. Diabetes Care 41(8):1749–1756. https://doi.org/10.2337/dc17-1955
Pelimanni E, Jehkonen M (2019) Type 2 Diabetes and Cognitive Functions in Middle Age: A Meta-Analysis. J Int Neuropsychol Soc 25(2):215–229. https://doi.org/10.1017/S1355617718001042
Samoilova YG, Rotkank MA, Zhukova NG, Matveeva MV, Tolmachev IV, Kudlay DA (2018) Markers for cognitive impairments and variability of glycaemia in patients with type 1 diabetes mellitus. Zh Nevrol Psikhiatr Im S S Korsakova 118(4):48–51. https://doi.org/10.17116/jnevro20181184148-51
Moheet A, Mangia S, Seaquist ER (2015) Impact of diabetes on cognitive function and brain structure. Ann N Y Acad Sci 1353:60–71. https://doi.org/10.1111/nyas.12807
Embury CM, Wiesman AI, McDermott TJ, Proskovec AL, Heinrichs-Graham E, Lord GH, Brau KL, Drincic AT, Desouza CV, Wilson TW (2019) The impact of type 1 diabetes on neural activity serving attention. Hum Brain Mapp 40(4):1093–1100. https://doi.org/10.1002/hbm.24431
Zhang YW, Zhang JQ, Liu C, Wei P, Zhang X, Yuan QY, Yin XT, Wei LQ, Cui JG, Wang J (2015) Memory dysfunction in type 2 diabetes mellitus correlates with reduced hippocampal CA1 and subiculum volumes. Chin Med J (Engl) 128(4):465–471. https://doi.org/10.4103/0366-6999.151082
Zilliox LA, Chadrasekaran K, Kwan JY, Russell JW (2016) Diabetes and Cognitive Impairment. Curr Diab Rep 16(9):87. https://doi.org/10.1007/s11892-016-0775-x
Ding X, Fang C, Li X, Cao YJ, Zhang QL, Huang Y, Pan J, Zhang X (2019) Type 1 diabetes-associated cognitive impairment and diabetic peripheral neuropathy in Chinese adults: results from a prospective cross-sectional study. BMC Endocr Disord 19(1):34. https://doi.org/10.1186/s12902-019-0359-2
Roy S, Kim N, Desai A, Komaragiri M, Baxi N, Jassil N, Blessinger M, Khan M, Cole R, Desai N, Terrigno R, Hunter K (2015) Cognitive Function and Control of Type 2 Diabetes Mellitus in Young Adults. N Am J Med Sci 7(5):220–226. https://doi.org/10.4103/1947-2714.157627
Sun L, Diao X, Gang X, Lv Y, Zhao X, Yang S, Gao Y, Wang G (2020) Risk Factors for Cognitive Impairment in Patients with Type 2 Diabetes. J Diabetes Res 2020:4591938. https://doi.org/10.1155/2020/4591938
Gandek B, Sinclair SJ, Kosinski M, Ware JE Jr (2004) Psychometric evaluation of the SF-36 health survey in Medicare managed care. Health Care Financ Rev 25(4):5–25.
Ware JE Jr (2000) SF-36 health survey update. Spine (Phila Pa 1976) 25(24):3130–3139. https://doi.org/10.1097/00007632-200012150-00008
Brickenkamp R (2012) d2, Test de Atención: Manual. Adaptación española: Nicolas Seisdedos Cubero. 4ed. Madrid: TEA Ediciones, S.A.U. I.S.B.N.:978-84-15262-68-8
Sidorov KR (2012) Qualitative Assessment of the Efficiency of Attention in the Methodology of “Cancellation Test” by B. Bourdon. Bull. Udmurt State University 4: 50–57. (In Russ).
Lin J-D, Chen Y-L, Wu C-Z, Hsieh C-H, Pei D, Liang Y-J, Chang J-B (2016) Identification of Normal Blood Pressure in Different Age Group. Medicine (Baltimore) 95(14): e3188. https://doi.org/10.1097/MD.0000000000003188
Eguchi K (2015) Blood Pressure Management in Patients with Type 2 Diabetes. Intern Med 54(18):2285–2289. https://doi.org/10.2169/internalmedicine.54.5617
Dederer J, Bewarder Y, Mahfoud F, Böhm M (2019) Blutdruckziele bei Patienten mit Diabetes mellitus : Was sind optimale Werte? [Blood pressure targets in patients with diabetes mellitus : What are optimum values?]. Herz 44(3):231–237. German. https://doi.org/10.1007/s00059-019-4796-5
Mokhtari Z, Gheshlagh RG, Kurdi A (2019) Health-related quality of life in Iranian patients with type 2 diabetes: An updated meta-analysis. Diabetes Metab Syndr 13(1):402–407. https://doi.org/10.1016/j.dsx.2018.10.007
Krzemińska S, Bąk E, Šáteková L, Polanská A, Hašová K, Laurinc M (2020) Comparison of Diabetes-Dependent Quality of Life (ADDQoL) in Patients with T2DM in Poland, The Czech Republic, and Slovakia. Diabetes Metab Syndr Obes 13:3773–3786. https://doi.org/10.2147/DMSO.S273339
Zurita-Cruz JN, Manuel-Apolinar L, Arellano-Flores ML, Gutierrez-Gonzalez A, Najera-Ahumada AG, Cisneros-González N (2018) Health and quality of life outcomes impairment of quality of life in type 2 diabetes mellitus: a cross-sectional study. Health Qual Life Outcomes 16(1):94. https://doi.org/10.1186/s12955-018-0906-y
Jing X, Chen J, Dong Y, Han D, Zhao H, Wang X, Gao F, Li C, Cui Z, Liu Y, Ma J (2018) Related factors of quality of life of type 2 diabetes patients: a systematic review and meta-analysis. Health Qual Life Outcomes 16(1):189. https://doi.org/10.1186/s12955-018-1021-9
Abdul-Rasoul M, AlOtaibi F, Abdulla A, Rahme Z, AlShawaf F (2013) Quality of life of children and adolescents with type 1 diabetes in Kuwait. Med Princ Pract 22(4):379–384. https://doi.org/10.1159/000347052
Bhavani N, Prince S, Menon AS, Abraham N, Pavithran PV, Menon UV, Nair V, Kumar H (2021) Health related quality of life in pediatric onset Type 1 diabetes mellitus in Kerala, India. Pediatr Diabetes 22(2):369–373. https://doi.org/10.1111/pedi.13151
Spasić A, Radovanović R, Đorđević A, Stefanović N, Cvetković T (2014) Quality of Life in Type 2 Diabetic Patients. Acta Facultatis Medicae Naissensis 31(3):193–200. https://doi.org/10.2478/afmnai-2014-0024
Prasanna Kumar HR, Mahesh MG, Menon VB, Srinath KM, Shashidhara KC, Ashok P (2018) Patient Self-reported quality of life assessment in Type 2 diabetes mellitus: A pilot study. Niger J Clin Pract 21(3):343–349. https://doi.org/10.4103/njcp.njcp_433_16
Bąk E, Nowak-Kapusta Z, Dobrzyn-Matusiak D, Marcisz-Dyla E, Marcisz C, Krzemińska SA (2019) An assessment of diabetes-dependent quality of life (ADDQoL) in women and men in Poland with type 1 and type 2 diabetes. Ann Agric Environ Med 26(3):429–438. https://doi.org/10.26444/aaem/99959
McCrimmon RJ, Ryan CM, Frier BM (2012) Diabetes and cognitive dysfunction. Lancet 379(9833):2291–2299. https://doi.org/10.1016/S0140-6736(12)60360-2
Ryan CM, van Duinkerken E, Rosano C (2016) Neurocognitive consequences of diabetes. Am Psychol 71(7):563–576. https://doi.org/10.1037/a0040455
Biessels GJ, Despa F (2018) Cognitive decline and dementia in diabetes mellitus: mechanisms and clinical implications. Nat Rev Endocrinol 14(10):591–604. https://doi.org/10.1038/s41574-018-0048-7
Lee HJ, Seo HI, Cha HY, Yang YJ, Kwon SH, Yang SJ (2018) Diabetes and Alzheimer’s Disease: Mechanisms and Nutritional Aspects. Clin Nutr Res 7(4):229–240. https://doi.org/10.7762/cnr.2018.7.4.229
Zhao X, Han Q, Lv Y, Sun L, Gang X, Wang G (2017) Biomarkers for cognitive decline in patients with diabetes mellitus: evidence from clinical studies. Oncotarget 9(7):7710–7726. https://doi.org/10.18632/oncotarget.23284
Mayeda ER, Whitmer RA, Yaffe K (2015) Diabetes and cognition. Clin Geriatr Med 31(1):101–115. ix. https://doi.org/10.1016/j.cger.2014.08.021
Brismar T, Maurex L, Cooray G, Juntti-Berggren L, Lindström P, Ekberg K, Adner N, Andersson S (2007) Predictors of cognitive impairment in type 1 diabetes. Psychoneuroendocrinology 32(8–10):1041–1051. https://doi.org/10.1016/j.psyneuen.2007.08.002
Trujeque-Ramos S, Castillo-Rolón D, Galarraga E, Tapia D, Arenas-López G, Mihailescu S, Hernández-López S (2018) Insulin Regulates GABAA Receptor-Mediated Tonic Currents in the Prefrontal Cortex. Front Neurosci 12:345. https://doi.org/10.3389/fnins.2018.00345
Ghasemi R, Haeri A, Dargahi L, Mohamed Z, Ahmadiani A (2013) Insulin in the brain: sources, localization and functions. Mol Neurobiol 47(1):145–171. https://doi.org/10.1007/s12035-012-8339-9
Arnold SE, Arvanitakis Z, Macauley-Rambach SL, Koenig AM, Wang HY, Ahima RS, Craft S, Gandy S, Buettner C, Stoeckel LE, Holtzman DM, Nathan DM (2018) Brain insulin resistance in type 2 diabetes and Alzheimer disease: concepts and conundrums. Nat Rev Neurol 14(3):168–181. https://doi.org/10.1038/nrneurol.2017.185
Arvanitakis Z, Wang HY, Capuano AW, Khan A, Taïb B, Anokye-Danso F, Schneider JA, Bennett DA, Ahima RS, Arnold SE (2020) Brain Insulin Signaling, Alzheimer Disease Pathology, and Cognitive Function. Ann Neurol 88(3):513–525. https://doi.org/10.1002/ana.25826
Gaddam M, Singh A, Jain N, Avanthika C, Jhaveri S, De la Hoz I, Sanka S, Goli SR (2021) A Comprehensive Review of Intranasal Insulin and Its Effect on the Cognitive Function of Diabetics. Cureus 13(8):e17219. https://doi.org/10.7759/cureus.17219
Benedict C, Hallschmid M, Schmitz K, Schultes B, Ratter F, Fehm HL, Born J, Kern W (2007) Intranasal insulin improves memory in humans: superiority of insulin aspart. Neuropsychopharmacology 32(1):239–243. https://doi.org/10.1038/sj.npp.1301193
Ritze Y, Kern W, Ebner EM, Jahn S, Benedict C, Hallschmid M (2018) Metabolic and Cognitive Outcomes of Subchronic Once-Daily Intranasal Insulin Administration in Healthy Men. Front Endocrinol (Lausanne) 13(9):663. https://doi.org/10.3389/fendo.2018.00663
Shemesh E, Rudich A, Harman-Boehm I, Cukierman-Yaffe T (2012) Effect of intranasal insulin on cognitive function: a systematic review. J Clin Endocrinol Metab 97(2):366–376. https://doi.org/10.1210/jc.2011-1802
Gao Y, Xiao Y, Miao R, Zhao J, Zhang W, Huang G, Ma F (2015) The characteristic of cognitive function in Type 2 diabetes mellitus. Diabetes Res Clin Pract 109(2):299–305. https://doi.org/10.1016/j.diabres.2015.05.019
Jeste DV (2019) Frailty and mental health: association with cognition, sleep, and well-being in older adults. Int Psychogeriatr 31(6):755–757. https://doi.org/10.1017/S1041610219000863
Author information
Authors and Affiliations
Contributions
Work idea and experiment planning (T.N.), subject recruitment and data collection (G.M., S.A.), statistical analysis and writing of the manuscript (T.N., T.A.), editing of the manuscript (Kh.A., T.A.).
Corresponding author
Ethics declarations
CONFLICTS OF INTEREST
The authors declare no obvious and potential conflicts of interest relevant to this article.
Additional information
Translated by N. Tadevosyan
Russian Text © The Author(s), 2022, published in Rossiiskii Fiziologicheskii Zhurnal imeni I.M. Sechenova, 2022, Vol. 108, No. 4, pp. 455–473https://doi.org/10.31857/S0869813922040082.
Rights and permissions
About this article
Cite this article
Tadevosyan, N.E., Khachunts, A.S., Gohargani, M. et al. Voluntary Attention and Quality of Life in Patients With Type 1 and Type 2 Diabetes Mellitus: Differences in Changes Depending on Disease Type and Duration. J Evol Biochem Phys 58, 569–584 (2022). https://doi.org/10.1134/S0022093022020247
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1134/S0022093022020247