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The Relationship Between Glucose Control and Cognitive Function in People With Diabetes After a Lacunar Stroke
Journal article   Open access   Peer reviewed

The Relationship Between Glucose Control and Cognitive Function in People With Diabetes After a Lacunar Stroke

Tali Cukierman-Yaffe, Leslie A. McClure, Thomas Risoli, Jackie Bosch, Mike Sharma, Hertzel C. Gerstein and Oscar Benavente
The journal of clinical endocrinology and metabolism, v 106(4), pp E1521-E1528
01 Apr 2021
PMID: 33481011
url
https://doi.org/10.1210/clinem/dgab022View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze) Open

Abstract

Endocrinology & Metabolism Life Sciences & Biomedicine Science & Technology
Context: Lacunar strokes and diabetes are risk factors for cognitive dysfunction. Elucidating modifiable risk factors for cognitive dysfunction has great public health implications. One factor may be glycemic status, as measured by glycated hemoglobin (A(1c)). Objective: The aim of this study was to assess the relationship between A(1c) and cognitive function in lacunar stroke patients with diabetes. Methods: The effect of baseline and follow-up A(1c) on the baseline and the change in Cognitive Assessment Screening Instrument (CASI) score over time among participants with a median of 2 cognitive assessments (range, 1-5) was examined in 942 individuals with diabetes and a lacunar stroke who participated in the Secondary Prevention of Small Subcortical Strokes (SPS3) trial (ClinicalTrials.gov No. NCT00059306). Results: Every 1% higher baseline A(1c) was associated with a 0.06 lower standardized CASI z score (95% CI, -0.101 to -0.018). Higher baseline A(1c) values were associated with lower CASI z scores over time (P for interaction =.037). A 1% increase in A(1c) over time corresponded with a CASI score decrease of 0.021 (95% CI, -0.0043 to -0.038) during follow-up. All these remained statistically significant after adjustment for age, sex, education, race, depression, hypertension, hyperlipidemia, body mass index, cardiovascular disease, obstructive sleep apnea, diabetic retinopathy, nephropathy insulin use, and white-matter abnormalities. Conclusion: This analysis of lacunar stroke patients with diabetes demonstrates a relationship between A(1c) and change in cognitive scores over time. Intervention studies are needed to delineate whether better glucose control could slow the rate of cognitive decline in this high-risk population.

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Collaboration types
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Web of Science research areas
Endocrinology & Metabolism
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