title: Association of GA/HbA1c ratio and cognitive impairment in subjects with type 2 diabetes mellitus.
abstract: The aim of this study was to search for factors influencing cognitive impairment and to clarify the association between the fluctuation of blood glucose levels and cognitive impairment in elderly Japanese subjects with type 2 diabetes.
  
  
  
  We recruited 88 relatively elderly subjects (≥65years old) with type 2 diabetes who were hospitalized in Kawasaki Medical School from January 2014 to December 2015. We evaluated the fluctuation of blood glucose levels with glycoalbumin (GA)/hemoglobin A1c (HbA1c) ratio, and estimated cognitive impairment with Hasegawa dementia scale-revised (HDS-R) score and mini mental state examination (MMSE) score.
  
  
  
  Multivariate analyses showed that GA/HbA1c ratio and urinary albumin excretion, but not hypoglycemia, were independent determinant factors for cognitive impairment in elderly Japanese subjects with type 2 diabetes.
  
  
  
  The fluctuation of blood glucose levels per se is closely associated with cognitive impairment in elderly subjects with type 2 diabetes even when hypoglycemia is not accompanied. Since it is very easy to calculate GA/HbA1c ratio, we should check this ratio so that we can reduce the fluctuation of blood glucose levels especially in elderly subjects with type 2 diabetes.
authors: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School.
authors: Tomoe
authors: T
authors: Kinoshita
authors: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School.
authors: Masashi
authors: M
authors: Shimoda
authors: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School.
authors: Junpei
authors: J
authors: Sanada
authors: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School.
authors: Yoshiro
authors: Y
authors: Fushimi
authors: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School.
authors: Yurie
authors: Y
authors: Hirata
authors: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School.
authors: Shintaro
authors: S
authors: Irie
authors: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School.
authors: Akihito
authors: A
authors: Tanabe
authors: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School.
authors: Atsushi
authors: A
authors: Obata
authors: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School.
authors: Tomohiko
authors: T
authors: Kimura
authors: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School.
authors: Hidenori
authors: H
authors: Hirukawa
authors: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School.
authors: Kenji
authors: K
authors: Kohara
authors: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School.
authors: Fuminori
authors: F
authors: Tatsumi
authors: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School.
authors: Shinji
authors: S
authors: Kamei
authors: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School.
authors: Shuhei
authors: S
authors: Nakanishi
authors: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School.
authors: Tomoatsu
authors: T
authors: Mune
authors: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School.
authors: Kohei
authors: K
authors: Kaku
authors: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School. Electronic address: kaneto@med.kawasaki-m.ac.jp.
authors: Hideaki
authors: H
authors: Kaneto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000097:blood / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D007003:Hypoglycemia; D007564:Japan; D008297:Male; D000075462:Serum Albumin, Human / Q000032:analysis*
chemical_list: D006442:Glycated Hemoglobin; D000075462:Serum Albumin, Human
keywords: Cognitive impairment; GA/HbA1c ratio; Hasegawa dementia scale-revised; Hypoglycemia; Type 2 diabetes mellitus