Effects of Acute Insulin-Induced Hypoglycemia on Spatial Abilities in Adults With Type 1 Diabetes

Wright, Rohana J.; Frier, Brian M.; Deary, Ian J.

doi:10.2337/dc09-0212

Cited by 36 publications

(23 citation statements)

References 21 publications

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“…During acute insulin-induced hypoglycemia, individuals with T1DM revealed a significant deterioration in spatial abilities [50] and performance impairments in tests of immediate verbal and visual memory, with working and delayed memories being the most affected cognitive domains [51]. On the other hand, the attempts to determine the impact of recurrent hypoglycemia on cognition resulted in controversial findings.…”

Section: Type 1 Diabetes Mellitusmentioning

confidence: 98%

Hyperglycemia, Hypoglycemia and Dementia: Role of Mitochondria and Uncoupling Proteins

Cardoso¹,

Correia²,

Santos³

et al. 2013

CMM

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Diabetes mellitus is one of the most prevalent chronic diseases. Since glucose is the main fuel of the brain, its levels should be maintained within a narrow range to ensure normal brain function. Indeed, the literature shows that uncontrolled blood glucose levels, whether too high or too low, impact brain structure and function potentiating cognitive impairment. Uncoupling proteins (UCPs) are a family of mitochondrial anion carrier proteins located on the inner mitochondrial membrane, and their primary function is to leak protons from the intermembrane space into the mitochondrial matrix. The specific role of neuronal UCPs has been widely discussed and although there is no general agreement, there is a strong conviction that these proteins may be involved in the defense against mitochondrial reactive oxygen species (ROS) production and, consequently, protecting against oxidative damage. The generation of ROS is increasingly recognized as playing an important role in diabetes, neurodegenerative disorders and aging where mitochondria are both sources and targets of these reactive species. This review examines the neurodegenerative events associated with diabetes, highlighting the role of hyperglycemia and/or hypoglycemia on cognitive function. The role of mitochondria, neuronal UCPs and their impact in central nervous system will be elucidated. Finally, we will discuss neuronal UCPs as possible therapeutic targets for the treatment of diabetes-associated central complications and neurodegenerative diseases, namely Alzheimer's and Parkinson's diseases.

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Section: Type 1 Diabetes Mellitusmentioning

confidence: 98%

Hyperglycemia, Hypoglycemia and Dementia: Role of Mitochondria and Uncoupling Proteins

Cardoso¹,

Correia²,

Santos³

et al. 2013

CMM

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show abstract

“…34 While driving, patients may be able to maintain their grip on the steering wheel, yet become disoriented as to their driving location and direction of navigation. Driving the wrong way on a residential street would be an example of spatial impairment.…”

Section: Risks Of Driving While Experiencing Hypoglycemiamentioning

confidence: 99%

Educating Patients About Hypoglycemia Prevention and Self-Management

Unger¹

2013

Clinical Diabetes

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Case PresentationMrs. B was a 68-year-old, AsianAmerican woman with a 15-year history of type 2 diabetes. Her coexisting medical conditions included unilateral intraductal carcinoma of the breast, which was treated with a modified radical mastectomy 6 years ago and showed no evidence of recurrence. Although there was no history of alcohol use, her liver function studies had been elevated to two times the upper limit of normal for several years. A liver biopsy revealed the presence of nonalcoholic steatohepatitis (NASH). She was admitted to the hospital on one occasion within the past year for bleeding esophageal varices.Mrs. B had no history of macrovascular disease, chronic kidney disease, retinopathy, or neuropathy. For the past 10 years, she had taken 10 mg glyburide daily. Her primary care provider (PCP) was concerned that her A1C had increased from 7.4 to 7.9% in the past 6 months.Her family members stated that they rarely spoke about diabetes, selfmonitoring of blood glucose (SMBG), or diabetes-related complications. In fact, the patient's 72-year-old husband also has type 2 diabetes and is undergoing dialysis. In the past year, Mr. B has had at least two episodes of severe hypoglycemia that required hospitalization. He blames his end-stage renal disease on medication he is taking to control his blood glucose levels.Because of concerns about Mrs. B's increasing A1C, her PCP asked her to consult with a local endocrinologist who added basal insulin to her diabetes treatment regimen. She was not provided with any specific instructions about how to inject the basal insulin or when to perform SMBG. Her son noted that she tended to get "confused," but he did not attribute this to her blood glucose level because he never saw her checking her glucose. Her handwritten glucose log showed several readings in the low 50 to 60 mg/dl range, but a pattern of hypoglycemia could not be determined.One month after beginning the combination therapy of glyburide and basal insulin, Mrs. B was observed to be driving 90 mph in the wrong direction on a residential street. After swerving to miss several cars, she lost control of her vehicle, hit a tree, and was killed on impact.

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“…In adults, the executive function and memory function were both significantly affected by severe hypoglycaemia [53,55,58,[72][73][74][75][76][77][78][79][80].…”

Section: Hypoglycaemiamentioning

confidence: 99%

“…No significant differences in cognitive function were found in verbal IQ, performance IQ, executive function, memory and motor function [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42]. Adults on the other hand showed significantly lowered performance on the executive function, general IQ (full, verbal and performance IQ), spatial memory and motor speed [43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58]compared to non-diabetic adults.…”

Section: Diabetes Associated Cognitive Declinementioning

confidence: 99%

Diabetes Associated Cognitive Decline, is there a Role for Exercise?

Tonoli¹,

Heyman

Roelands³

et al. 2013

J Diabetes Metab

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Type 1 Diabetes (T1D) can have a significant impact on brain structure and function. This so-called 'diabetesassociated cognitive decline' (DACD) can be attributed to diverse biochemical and neurochemical pathways which are caused by hyperglycaemia, hypoglycaemia, but also by c-peptide and insulin deficiency. Besides the positive effects of exercise on the acute and chronic glycaemic control in T1D patients, a growing number of studies also documented the beneficial influence of exercise on aspects of cognition and performance. Therefore, the purpose of the present narrative review is to discuss the associative aspects between a DACD and its' proposed mechanisms and the potential beneficial effect of exercise on a DACD.

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Effects of Acute Insulin-Induced Hypoglycemia on Spatial Abilities in Adults With Type 1 Diabetes

Cited by 36 publications

References 21 publications

Hyperglycemia, Hypoglycemia and Dementia: Role of Mitochondria and Uncoupling Proteins

Hyperglycemia, Hypoglycemia and Dementia: Role of Mitochondria and Uncoupling Proteins

Educating Patients About Hypoglycemia Prevention and Self-Management

Diabetes Associated Cognitive Decline, is there a Role for Exercise?

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