Nocturnal hypoglycemia is associated with next day cognitive performance in adults with type 1 diabetes: Pilot data from the GluCog study.

IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Clinical Neuropsychologist Pub Date : 2024-10-01 Epub Date: 2024-02-21 DOI:10.1080/13854046.2024.2315749
Miranda Zuniga-Kennedy, Olivia H Wang, Luciana M Fonseca, Michael J Cleveland, Jane D Bulger, Elizabeth Grinspoon, Devon Hansen, Zoë W Hawks, Laneé Jung, Shifali Singh, Martin Sliwinski, Alandra Verdejo, Kellee M Miller, Ruth S Weinstock, Laura Germine, Naomi Chaytor
{"title":"Nocturnal hypoglycemia is associated with next day cognitive performance in adults with type 1 diabetes: Pilot data from the GluCog study.","authors":"Miranda Zuniga-Kennedy, Olivia H Wang, Luciana M Fonseca, Michael J Cleveland, Jane D Bulger, Elizabeth Grinspoon, Devon Hansen, Zoë W Hawks, Laneé Jung, Shifali Singh, Martin Sliwinski, Alandra Verdejo, Kellee M Miller, Ruth S Weinstock, Laura Germine, Naomi Chaytor","doi":"10.1080/13854046.2024.2315749","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong> Individuals with type 1 diabetes (T1D) have increased risk for cognitive dysfunction and high rates of sleep disturbance. Despite associations between glycemia and cognitive performance using cross-sectional and experimental methods few studies have evaluated this relationship in a naturalistic setting, or the impact of nocturnal versus daytime hypoglycemia. Ecological Momentary Assessment (EMA) may provide insight into the dynamic associations between cognition, affective, and physiological states. The current study couples EMA data with continuous glucose monitoring (CGM) to examine the within-person impact of nocturnal glycemia on next day cognitive performance in adults with T1D. Due to high rates of sleep disturbance and emotional distress in people with T1D, the potential impacts of sleep characteristics and negative affect were also evaluated.</p><p><strong>Methods: </strong> This pilot study utilized EMA in 18 adults with T1D to examine the impact of glycemic excursions, measured using CGM, on cognitive performance, measured <i>via</i> mobile cognitive assessment using the TestMyBrain platform. Multilevel modeling was used to test the within-person effects of nocturnal hypoglycemia and hyperglycemia on next day cognition.</p><p><strong>Results: </strong> Results indicated that increases in nocturnal hypoglycemia were associated with slower next day processing speed. This association was not significantly attenuated by negative affect, sleepiness, or sleep quality.</p><p><strong>Conclusions: </strong> These results, while preliminary due to small sample size, showcase the power of intensive longitudinal designs using ambulatory cognitive assessment to uncover novel determinants of cognitive fluctuation in real world settings, an approach that may be utilized in other populations. Findings suggest reducing nocturnal hypoglycemia may improve cognition in adults with T1D.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":null,"pages":null},"PeriodicalIF":3.0000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11336034/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Neuropsychologist","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1080/13854046.2024.2315749","RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/2/21 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Objective:  Individuals with type 1 diabetes (T1D) have increased risk for cognitive dysfunction and high rates of sleep disturbance. Despite associations between glycemia and cognitive performance using cross-sectional and experimental methods few studies have evaluated this relationship in a naturalistic setting, or the impact of nocturnal versus daytime hypoglycemia. Ecological Momentary Assessment (EMA) may provide insight into the dynamic associations between cognition, affective, and physiological states. The current study couples EMA data with continuous glucose monitoring (CGM) to examine the within-person impact of nocturnal glycemia on next day cognitive performance in adults with T1D. Due to high rates of sleep disturbance and emotional distress in people with T1D, the potential impacts of sleep characteristics and negative affect were also evaluated.

Methods:  This pilot study utilized EMA in 18 adults with T1D to examine the impact of glycemic excursions, measured using CGM, on cognitive performance, measured via mobile cognitive assessment using the TestMyBrain platform. Multilevel modeling was used to test the within-person effects of nocturnal hypoglycemia and hyperglycemia on next day cognition.

Results:  Results indicated that increases in nocturnal hypoglycemia were associated with slower next day processing speed. This association was not significantly attenuated by negative affect, sleepiness, or sleep quality.

Conclusions:  These results, while preliminary due to small sample size, showcase the power of intensive longitudinal designs using ambulatory cognitive assessment to uncover novel determinants of cognitive fluctuation in real world settings, an approach that may be utilized in other populations. Findings suggest reducing nocturnal hypoglycemia may improve cognition in adults with T1D.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
夜间低血糖与 1 型糖尿病成人患者第二天的认知表现有关:来自 GluCog 研究的试验数据。
目的: 1 型糖尿病(T1D)患者认知功能障碍的风险增加,睡眠障碍的发生率也很高。尽管采用横断面和实验方法研究了血糖与认知能力之间的关系,但很少有研究在自然环境中评估这种关系,或夜间低血糖与白天低血糖的影响。生态瞬间评估(EMA)可以帮助人们深入了解认知、情感和生理状态之间的动态关联。目前的研究将 EMA 数据与连续血糖监测 (CGM) 结合起来,研究 T1D 成人患者夜间血糖对第二天认知能力的影响。由于 T1D 患者的睡眠障碍和情绪困扰发生率较高,因此还评估了睡眠特征和负面情绪的潜在影响: 这项试验性研究利用 18 名 T1D 成人患者的 EMA 来研究血糖偏移对认知能力的影响,血糖偏移是通过 CGM 测量的,而认知能力是通过使用 TestMyBrain 平台的移动认知评估测量的。研究采用多层次模型来检验夜间低血糖和高血糖对第二天认知能力的影响: 结果表明,夜间低血糖的增加与次日处理速度的减慢有关。负性情绪、嗜睡或睡眠质量都不会明显降低这种关联: 由于样本量较小,这些结果只是初步的,但它们展示了利用非卧床认知评估进行强化纵向设计的能力,从而发现了现实环境中认知波动的新决定因素,这种方法可用于其他人群。研究结果表明,减少夜间低血糖可改善患有 T1D 的成年人的认知能力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Clinical Neuropsychologist
Clinical Neuropsychologist 医学-临床神经学
CiteScore
8.40
自引率
12.80%
发文量
61
审稿时长
6-12 weeks
期刊介绍: The Clinical Neuropsychologist (TCN) serves as the premier forum for (1) state-of-the-art clinically-relevant scientific research, (2) in-depth professional discussions of matters germane to evidence-based practice, and (3) clinical case studies in neuropsychology. Of particular interest are papers that can make definitive statements about a given topic (thereby having implications for the standards of clinical practice) and those with the potential to expand today’s clinical frontiers. Research on all age groups, and on both clinical and normal populations, is considered.
期刊最新文献
Interpreting the direct- and derived-Trail Making Test scores in Argentinian children: regression-based norms, convergent validity, test-retest reliability, and practice effects. Enhanced detection of suboptimal effort in psychoeducational assessments for dyslexia. Neuropsychological normative standards for late career physicians. Naturalistic assessment of everyday multitasking in Parkinson's disease with and without mild cognitive impairment. Utility of learning ratio scores from the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Word List Memory Test in distinguishing patterns of cognitive decline in veterans referred for neuropsychological evaluation.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1