Working Memory Characteristics Of Type 2 Diabetic Patients With Different Self-management Levels

Objectives The N-back experimental paradigm of cognitive behavioral science was used to investigate the working memory characteristics of verbal and visual-spatial in type 2 diabetes patients under low,medium and high load conditions.To explore in patients with type 2 diabetes working memory and processing characteristics and the link between the self-management level.To provide the basis for the intervention of working memory training to improve the self-management behavior of patients with type 2 diabetes.Methods Convenience sampling method selected 190 T2 DM patients admitted to the department of endocrinology of a third-class a hospital in Anhui province from March2018 to July 2018 as research objects,and completed the questionnaire survey and behavioral experiment in a quiet laboratory in a one-to-one manner.Questionnaire survey:(1)the General Information Questionnaire to collect general demographic data(age,gender,residence,level of education,marital status,etc.),disease information(treatment methods,duration of diabetes,complications,etc.)and laboratory indexes(fasting plasma glucose,2-hour postprandial blood glucose,hemoglbin A1 c,etc.)(2)Diabetes Self-Management Activity Questionnaire was used to collect self-management behavior data of patients,such as diet,exercise,blood glucose monitoring,foot care and taking medicine as prescribed by doctors.Behavioral experiment: E-prime program was used to design N-back experiment task to record patients' response time and accuracy rate to verbal and visual-spatial working memory.The subjects were divided into three groups with high,medium and low self-management level according to the three-digit score of Diabetes Self-Management Questionnaire.Three factors 3(group)× 2(verbal and visual-spatial working memory)× 3(working memory load)were used to analyze the characteristics of verbal and visual-spatial working memory of patients with type 2 diabetes with different levels of self-management under three load conditions.Results(1)T2DM patients with different self-management levels showed no statistically significant differences in gender,residence,education,marital status,family monthly income,BMI,treatment methods,fasting blood glucose and 2-hour postprandial blood glucose(P>0.05).There were statistically significant differences in age,number of complications,duration of disease,and hemoglbin A1 c among T2 DM patients with different levels of self-management(P<0.05).(2)T2DM patients showed statistically significant differences in response time and accuracy rate to the three load verbal and visual-spatial working memory tasks(all P<0.001).T2 DM patients had the longest response time at high load and the shortest response time at low load,the accuracy rate of high-load working memory task was the lowest and that of low-load working memory task was the highest.There were statistically significant differences in response time and accuracy between T2 DM patients in verbal and visual-spatial working memory tasks(all P<0.001).The response time of visual-spatial working memory task was longer than that of verbal working memory task,the accuracy rate of visual-spatial working memory task was lower than that of verbal working memory task.(3)The differences in response time of T2 DM patients with different self-management levels were statistically significant in the three load verbal and visual-spatial working memory(all P<0.001).Patients with low self-management level had the longest reaction time,patients with high self-management level had the shortest reaction time,and patients with medium self-management level were all in the middle of patients with low and high self-management level.(4)In low-load verbal and visual-spatial working memory tasks,there was no statistically significant difference in the accuracy of T2 DM patients with different self-management levels(P=0.915,P=0.146).In the tasks of medium and high load verbal and visual-spatial working memory,those with low self-management level had the lowest accuracy,those with high self-management level had the highest accuracy,and those with medium self-management level were in the middle of those with low and high self-management level(P<0.001).Conclusions(1)Verbal and visual-spatialworking memory in T2 DM patients: With the increase of working memory load of verbal and visual-spatial,the required reaction time is longer and the accuracy rate is lower.Under the condition of fixed load conditions,the type of working memory is an important factor affecting the representation of working memory,and the response time required for visual-spatial working memory is long and the accuracy rate is low.(2)Verbal and visual-spatial working memory in patients with low self-management T2DM: There was no difference in the accuracy rate of patients with low self-management level between those with medium and high self-management level in low load verbal and visual-spatial working memory tasks.However,the accuracy of patients with low self-management level was significantly reduced when they had medium and high-load verbal and visual-spatial working memory.(3)Verbal and visual-spatial working memory in patients with intermediate level of self-management: the response time and accuracy rate of T2 DM patients with medium self-management level were between those with low self-management level and those with high self-management level.(4)Verbal and visual-spatial working memory in patients with high self-management level:T2DM patients with high self-management level have strong advantages in verbal and visual-spatial working memory response speed and accuracy.