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dc.contributor.authorVerhulst, Clementine EM
dc.contributor.authorFabricius, Therese W
dc.contributor.authorNefs, Giesje
dc.contributor.authorKessels, Roy PC
dc.contributor.authorPouwer, Frans
dc.contributor.authorTeerenstra, Steven
dc.contributor.authorTack, Cees J
dc.contributor.authorBroadley, Melanie M
dc.contributor.authorKristensen, Peter L
dc.contributor.authorMcCrimmon, Rory J
dc.contributor.authorHeller, Simon
dc.contributor.authorEvans, Mark L
dc.contributor.authorPedersen-Bjergaard, Ulrik
dc.contributor.authorde Galan, Bastiaan E
dc.date.accessioned2022-05-31T23:30:54Z
dc.date.available2022-05-31T23:30:54Z
dc.date.issued2022-09-01
dc.identifier.issn0149-5992
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/337653
dc.description.abstractOBJECTIVE: Hypoglycemia poses an immediate threat for cognitive function. Due to its association with acute cognitive impairment, the International Hypoglycemia Study Group (IHSG) defines a blood glucose level <3.0 mmol/L as "level 2 hypoglycemia." In the current study we investigated whether having diabetes, type of diabetes, or hypoglycemia awareness moderates this association. RESEARCH DESIGN AND METHODS: Adults with type 1 diabetes with normal (n = 26) or impaired (n = 21) hypoglycemic awareness or with insulin-treated type 2 diabetes (n = 15) and age-matched control subjects without diabetes (n = 32) underwent a hyperinsulinemic-euglycemic-hypoglycemic glucose clamp (2.80 ± 0.13 mmol/L [50.2 ± 2.3 mg/dL]). At baseline and during hypoglycemia, calculation ability, attention, working memory and cognitive flexibility were measured with the Paced Auditory Serial Addition Test (PASAT) and the Test of Attentional Performance (TAP). RESULTS: For the whole group, hypoglycemia decreased the mean ± SD proportion of correct answers on the PASAT by 8.4 ± 12.8%, increased reaction time on the TAP Alertness task by 32.1 ± 66.6 ms, and increased the sum of errors and omissions on the TAP Working Memory task by 2.0 ± 5.5 (all P < 0.001). Hypoglycemia-induced cognitive declines were largely irrespective of the presence or type of diabetes, level of symptomatic awareness, diabetes duration, or HbA1c. CONCLUSIONS: IHSG level 2 hypoglycemia impairs cognitive function in people with and without diabetes, irrespective of type of diabetes or hypoglycemia awareness status. These findings support the cutoff value of hypoglycemia <3.0 mmol/L (<54 mg/dL) as being clinically relevant for most people with diabetes.
dc.description.sponsorshipInnovative Medicines Initiative 2 Joint Undertaking (JU) under grant agreement No 777460. The JU receives support from the European Union’s Horizon 2020 research and innovation program and EFPIA and T1D Exchange, JDRF, International Diabetes Federation (IDF), The Leona M. and Harry B. Helmsley Charitable Trust.
dc.publisherAmerican Diabetes Association
dc.rightsAll Rights Reserved
dc.rights.urihttp://www.rioxx.net/licenses/all-rights-reserved
dc.titleConsistent Effects of Hypoglycemia on Cognitive Function in People With or Without Diabetes.
dc.typeArticle
dc.publisher.departmentDepartment of Medicine
dc.date.updated2022-05-31T13:00:17Z
prism.publicationNameDiabetes Care
dc.identifier.doi10.17863/CAM.85059
dcterms.dateAccepted2022-05-31
rioxxterms.versionofrecord10.2337/dc21-2502
rioxxterms.versionAM
dc.contributor.orcidVerhulst, Clementine EM [0000-0002-9905-7669]
dc.contributor.orcidPouwer, Frans [0000-0002-8172-9818]
dc.contributor.orcidTack, Cees J [0000-0003-0322-1653]
dc.contributor.orcidMcCrimmon, Rory J [0000-0002-3957-1981]
dc.contributor.orcidHeller, Simon [0000-0002-2425-9565]
dc.contributor.orcidPedersen-Bjergaard, Ulrik [0000-0003-0588-4880]
dc.contributor.orcidde Galan, Bastiaan E [0000-0002-1255-7741]
dc.identifier.eissn1935-5548
rioxxterms.typeJournal Article/Review
cam.issuedOnline2022-07-25
cam.orpheus.successWed Aug 03 09:45:45 BST 2022 - Embargo updated
cam.orpheus.counter6
cam.depositDate2022-05-31
pubs.licence-identifierapollo-deposit-licence-2-1
pubs.licence-display-nameApollo Repository Deposit Licence Agreement
rioxxterms.freetoread.startdate2022-07-25


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