Inoue Maki, Kusunoki Yoshiki, Ohigashi Mana, Osugi Keiko, Inoue Chikako, Otsuka Akihito, Azuma Daisuke, Ikeda Hiroki, Tamada Daisuke, Inagaki Tadahiro, Watanabe Nobuaki, Miyoshi Akio, Kanzaki Akinori, Kadoya Manabu, Konishi Kosuke, Koyama Hidenori
Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, Nishinomiya, Hyogo, Japan.
Kawasaki Hospital, Kobe, Hyogo, Japan.
Diabetes Obes Metab. 2025 Sep;27(9):4737-4746. doi: 10.1111/dom.16511. Epub 2025 Jun 16.
Type 2 diabetes mellitus (T2DM) is known to be a risk factor for cognitive dysfunction and dementia. Time in range (TIR), which is derived from continuous glucose monitoring (CGM), has been widely used as an indicator of the quality of glycemic control. While cross-sectional studies have reported an association between CGM-derived TIR and cognitive function scores, few studies have longitudinally investigated the relationship between the two. This study aimed to prospectively investigate the association between CGM-derived TIR and changes in multiple cognitive function scores.
The present study used baseline and 2-year data from an ongoing multicenter cohort study. This study included 197 T2DM patients aged ≥60 years with undiagnosed dementia. Participants were examined with the mini-mental state examination (MMSE), the Japanese version of the Montreal cognitive assessment (MoCA-J) and the digit symbol substitution test (DSST) at both baseline and 2 years. Multiple regression analyses were performed to investigate the association between TIR and changes in cognitive function test scores over 2 years.
Multivariate regression analysis showed that there was a significant association between TIR and changes in MMSE (ΔMMSE) over 2 years (standard partial regression coefficient [β] = 0.187, p = 0.005). Similarly, multivariate regression models showed a significant association between TIR and ΔMoCA-J (β = 0.218, p = 0.001) and ΔDSST (β = 0.164, p = 0.036).
In patients with T2DM with undiagnosed dementia, CGM-derived TIR might be associated with overall cognitive decline and reduced processing speed.
2型糖尿病(T2DM)是认知功能障碍和痴呆的已知危险因素。从连续血糖监测(CGM)得出的血糖达标时间(TIR)已被广泛用作血糖控制质量的指标。虽然横断面研究报告了CGM得出的TIR与认知功能评分之间的关联,但很少有研究纵向调查两者之间的关系。本研究旨在前瞻性调查CGM得出的TIR与多种认知功能评分变化之间的关联。
本研究使用了一项正在进行的多中心队列研究的基线数据和2年数据。本研究纳入了197名年龄≥60岁、未诊断出痴呆的T2DM患者。参与者在基线和2年时均接受简易精神状态检查(MMSE)、日语版蒙特利尔认知评估(MoCA-J)和数字符号替换测验(DSST)。进行多元回归分析以调查TIR与2年期间认知功能测试评分变化之间的关联。
多元回归分析显示,TIR与2年期间的MMSE变化(ΔMMSE)之间存在显著关联(标准偏回归系数[β]=0.187,p=0.005)。同样,多元回归模型显示TIR与ΔMoCA-J(β=0.218,p=0.001)和ΔDSST(β=0.164,p=0.036)之间存在显著关联。
在未诊断出痴呆的T2DM患者中,CGM得出的TIR可能与整体认知衰退和处理速度降低有关。