Cognitive disorders in type 2 diabetic patients with recognized depression.
OBJECTIVE
The most important factors in the pathogenesis of cognitive disorders in diabetes mellitus (DM) are metabolic changes directly caused by hyperglycemia. Impairment of cognitive function is accompanied by a decrease in cerebral insulin. Insulin improves cognitive processes, including somatosensoric cognitive functions. Cognitive disorders are especially pronounced if diabetic patients suffer also from depression.


METHODS
The evaluation of cognitive functions, especially sensomotoric skills were obtained from three study groups (aged 37-52 years): 30 healthy subjects, 40 diabetic patients with clinically documented depression and 30 depressive patients without DM. The sensomotoric skills were carried out using a SPS-2001E apparatus - a computer working stress simulator. The examination with Beck Depression Inventory (BDI) were also performed in all the investigated persons.


RESULTS
Sensomotoric skills investigation revealed slight cognitive disorders in the early stages DM (subgroup IA) and its intensification according to increasing BDI scores and HbA1c blood concentration (from subgroup IA to IC). Intensification of sensomotoric cognitive disorders was significantly higher (p<0.001) in the depressive patients with DM (group I), than in these without DM (group III).


CONCLUSIONS
The obtained results suggest that coincidence of aggravating factors, such as depression and metabolic disorders in DM, may cause mutual interactions leading to premature and more intense cognitive impairment. The method proposed by the authors may serve as a screening examination in early diagnosis of CNS disorders reflected by somatosensoric cognitive disorders. The presented work indicates importance of sensomotoric skills investigation for the early diagnosis of the nervous system damage related to DM.
Janocha
Anna
A
Department of Physiology, Wroclaw Medical University, Wrocław, Poland. ajanocha@fizjo.am.wroc.pl
Bolanowski
Marek
M
Pilecki
Witold
W
Małyszczak
Krzysztof
K
Salomon
Ewa
E
Woźniak
Wojciech
W
Skalik
Robert
R
Tumińska
Anna
A
Kałka
Dariusz
D
Sobieszczańska
Małgorzata
M
D000328:Adult; D003072:Cognition Disorders / Q000150:complications / Q000175:diagnosis*; D003863:Depression / Q000150:complications / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D011597:Psychomotor Performance
D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human