Liu Minli, Wang Zhiguo, Han Jiming, Mu Zhenzhen, Bian Hongyan
Medical College of Yan'an University, Yan'an, China.
Shanxi Provincial People's Hospital, Taiyuan, China.
Front Neurol. 2024 Aug 16;15:1419017. doi: 10.3389/fneur.2024.1419017. eCollection 2024.
Many studies have explored the risk factors associated with cognitive impairment in patients with Type 2 diabetes mellitus (T2DM). However, research on determining the optimal threshold for these risk factors and comparative studies on the therapeutic effects of insulin and metformin is limited. This study aims to establish the optimal threshold for cognitive impairment risk factors in T2DM patients and compare the efficacy of insulin and metformin in treating mild cognitive impairment (MCI).
A total of 308 patients with T2DM were included. The optimal threshold for cognitive impairment risk factors was determined using receiver operating characteristic curve and binary logistic regression models. MCI patients were divided into three groups: insulin, metformin, and insulin with metformin. The treatment effect was evaluated after a 6-month follow-up.
The study identified several factors that influenced cognitive function in T2DM patients, including female gender, duration of diabetes >13.50 years, years of education >7.50 years, and serum sodium level > 141.90 mmol/L. Metformin and insulin with metformin showed superior therapeutic effects compared to insulin alone, but no difference was observed between metformin and combination therapy.
Special attention should be given to female and those with diabetes duration >13.50 years, as well as to individuals with educational level ≤ 7.50 years and serum sodium concentration ≤ 141.90 mmol/L. Metformin and insulin with metformin effectively improve MCI in patients with T2DM and outperform insulin monotherapy. The efficacy of metformin and combination therapy was found to be comparable.
许多研究已经探讨了2型糖尿病(T2DM)患者认知障碍的相关危险因素。然而,关于确定这些危险因素的最佳阈值以及胰岛素和二甲双胍治疗效果的比较研究有限。本研究旨在确定T2DM患者认知障碍危险因素的最佳阈值,并比较胰岛素和二甲双胍治疗轻度认知障碍(MCI)的疗效。
共纳入308例T2DM患者。使用受试者工作特征曲线和二元逻辑回归模型确定认知障碍危险因素的最佳阈值。MCI患者分为三组:胰岛素组、二甲双胍组和胰岛素联合二甲双胍组。随访6个月后评估治疗效果。
该研究确定了几个影响T2DM患者认知功能的因素,包括女性、糖尿病病程>13.50年、受教育年限>7.50年和血清钠水平>141.90 mmol/L。与单独使用胰岛素相比,二甲双胍和胰岛素联合二甲双胍显示出更好的治疗效果,但二甲双胍与联合治疗之间未观察到差异。
应特别关注女性、糖尿病病程>13.50年的患者,以及受教育程度≤7.50年和血清钠浓度≤141.90 mmol/L的个体。二甲双胍和胰岛素联合二甲双胍可有效改善T2DM患者的MCI,且优于胰岛素单药治疗。发现二甲双胍与联合治疗的疗效相当。