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Review
. 2015 Jan;3(1):75-89.
doi: 10.1016/S2213-8587(14)70148-2. Epub 2014 Aug 24.

Glucose regulation, cognition, and brain MRI in type 2 diabetes: a systematic review

Stefan L C Geijselaers  1 , Simone J S Sep  1 , Coen D A Stehouwer  1 , Geert Jan Biessels  2
Affiliations
Review

Glucose regulation, cognition, and brain MRI in type 2 diabetes: a systematic review

Stefan L C Geijselaers et al. Lancet Diabetes Endocrinol. 2015 Jan.

Erratum in

  • Lancet Diabetes Endocrinol. 2015 Jan;3(1):e1

Abstract

Type 2 diabetes is associated with cognitive dysfunction and structural brain changes. Abnormalities in glucose regulation are involved in several complications related to type 2 diabetes, but their role in these cerebral complications is unclear. We systematically reviewed studies of the association between glucose regulation (glycaemia, hypoglycaemic events, insulin concentration, insulin resistance, and glucose-lowering treatment) and cognitive function and brain abnormalities on MRI in people with type 2 diabetes. The 86 papers included showed that glycaemia, particularly high HbA1c concentration and glucose variability, are negatively associated with cognitive function in people with type 2 diabetes without dementia. However, the strength of this association is weak, and HbA1c generally accounted for less than 10% of the variance in cognition. Importantly, few studies have measured long-term cerebral outcomes, such as dementia and structural brain changes on MRI, and the effect of glucose-lowering treatment on these outcomes. More randomised controlled trials are needed to establish the effect of glucose-lowering treatment on long-term cognitive function in people with type 2 diabetes.

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