Follow-Up Research Into Type 2 Diabetic Mild Cognitive Impairment

Objective 1.Diabetes was the dangerous factor of MCI.As the diabetes progresses, control over the blood sugar and change in the diabetes disease course and other factor impose influence upon the cognitive function.Therefore,it was necessary to conduct the follow-up research into change in the diabetic cognitive function;2.Two years of follow-up survey into change of the diabetic cognitive function and understanding about in what aspects these changes take place was made;3.Analysis was made about relevant factors that were prone to influence change of the cognitive function.Methods Type 2 Diabetics amount to 101.According to Petersen's MCI diagnostic standard and excluding standard,Clinical Memory Scale(CMS)was selected as the main measuring and evaluating tool for cognitive function.It was selected into the MCI group and the normal cognitive function group and survey was traced for two years.High Performance Liquid Chromatography(HPLC)was adopted to determine glucated hemoglobin level of the patient;finish determination of blood routine,blood fat,liver and kidney function;measure the blood pressure;conduct the cardiogram and skull CT examination.101 cases of Type 2 diabetics were divided into 4 groups according to diabetes disease course:new diagnostic diabetes group and diabetes disease course≤1 year group,diabetes disease course is 1-5 year group, and diabetes disease course≧5 year group;according to glucated hemoglobin value, they were divided into two groups:blood sugar control group and poor control group. For all data,t test,analysis of variance,x² test,beeline correlation analysis and logistic regression analysis were conduct,so as to get to know about the change of cognitive function and the influencing factors after initial visit and two years of follow-up visit to the diabetic,and observe relevant indices.Results Among the Type 2 Diabetics under test with follow-up data,the 31 cases in the MCI group and the 61 cases in the normal cognitive function group were subject to two years of follow-up visit.1.Two-year accumulated rate of sickness of MCI(42.2%)was increased as compared with the MCI sickness rate(32.7%)in time of initial visit,but there is no obvious statistical difference.2 Case transfer into dementia(6.5%). According to calculation of the follow-up surveyor,the rate that the diabetics with normal cognitive function transfer to MCI was 7.38·100^-1·year.2.Single factor analysis of variance showed that age(X²=10.654,P=0.005),hypertension (X²=4.483,P=0.034),hyperlipoproteinemia(X²=7.225,P=0.007)and blood sugar control(X²=8.894,P=0.003)are the influencing factor for MCI(P＜0.05),wherein blood sugar control(OR=0.286,P=0.011)and educational background(OR=0.472, P=0.030)were the protective element of MCI.At the same time,through analysis about a plurality of factors influencing transfer of the normal cognitive function into MCI,we found that blood sugar control(OR=0.001,P=0.013)is also a protective factor for transfer of diabetic into MCI.3.After follow-up research,the group with poor control over blood sugar has more reduction in MMSE,CMS,directed memory, associated study,free image representing,recognition of meaningless figure,and recollection ability of human figure,as compared with the group with good control over blood sugar.The difference provides the statistical significance(P＜0.05); compared with the initial visit,after 1 to 5 years of follow-up research into the diabetes disease course as well as after more than 5 years of follow-up research into the diabetes disease course,MMSE,CMS,directed memory,recognition of meaningless figure,and recollection ability of human figure was reduced.The difference provides the statistical significance.(P＜0.05)4.After relevant beeline analysis about change rate of MMSE,CMS and ADL as well as various factors including control over blood sugar and diabetes disease course respectively,it was found that control over blood sugar,diabetes disease course and blood pressure was relevant to the annual change rate of MMSE and CMS.Conclusions 1.After follow-up visit,two-year accumulated rate of sickness of MCI was increased as compared with the MCI sickness rate in time of initial visit.However,as the samples are small in amount and the follow-up time is short,so there is no obvious statistical difference.After follow-up visit,average annual rate of transfer from normal cognitive function to MCI was 7.38·100^-1·year.2.Control over blood sugar and the educational background was the protective factor of MCI.Hyperlipoproteinemia was an independent dangerous factor for MCI.Thus control over the blood sugar and blood fat was beneficial to improve the cognitive function of the Type 2 Diabetic of aged people.At the same time,control over blood sugar was a protective factor that influences the tested with diabetes normal cognitive function to transfer into MCI; while age was an independent dangerous factor.Therefore,we deem that diabetes was an estimated factor that influences the patient's reduction of cognitive function two years later.It coordinates with the aging course,causing ebbing of the cognitive function.3.After two-year follow-up visit to the diabetics,the patients with poor control over blood sugar has the reduction of memory function reflected in memory, associating study,free image memory,recognition of meaningless figure,and recollection ability of human figure,and the comprehensive memory function(CMS) was also reduced obviously.Patients with long diabetes disease course(with disease course of 1 to 5 years or disease course≧5 years)had their comprehensive memory function(CMS)reduced,reflecting in directed memory,recognition of meaningless figure,and recollection ability of human figure and damage of memory function was mainly reflected in the function of the right brain hemisphere(recognition of meaningless figure).That also indicated that level of diabetes disease course and blood sugar control played an important function to change of Type 2 Diabetes cognitive function(especially the memory function).4.Diabetes influences the speed and extent of ebbing of cognitive function through joint function of control over the disease course and blood sugar.Type 2 Diabetes was an important factor that influenced occurrence,development and result of the mild cognitive impairment (MCI),which was prone to be intensified by the extension of such diabetes disease course and aggravation of the control over blood sugar were increasing,so in the future early diagnosis and effective control over diabetes will have significant theoretic and realistic significances for reducing occurrence,postponement and development of MCI.