Status of cognitive function and depressive disorders in patients with type 2 diabetes in adulthood, depending on hypoglycemic therapy

Abstract

Aim. To study the state of cognitive function and the presence of depression disorders in patients with type 2 diabetes mellitus in adulthood, depending on the type of  hypoglycemic therapy. Materials and methods. 81 patients aged from 45 to 59 years were examined. All patients were divided into groups depending on the type of  hypoglycemic therapy. The 1st group included patient treated with diet therapy; the 2nd group — metformin; the 3rd group — sulfonylurea; the 5th group — metformin+sulfonylurea drugs (SUD) + inhibitors of dipeptidyl  eptidase 4 (DPP-4), glucagon-like peptide 1 (GLP-1) analog, inhibitors of sodium-glucouse  cotransporter type 2; 6th group — insulin; the 7th group — insulin + metformin + sulfonylurea drugs / insulin + metformin. To assess the state of cognitive functions  the following methods were used: test «5 words», Schulte test, minimental scale (MMSE), battery of tests for frontal dysfunction (BFD), and clock drawing test. The  questionnaire Centre for Epidemiologic Studies Depression Scale (CES-D) and Hospital Anxiety and Depression (HAD) scale were used to determine the depression.  Results. The highest percentage of severe depression manifestations was observed in the group of patients treated by insulin+SUD — 49.49%, while  patients with severe depression manifestations treated by metformin and metformin + sulfonylurea drugs, DPP-4, GLP-1, inhibitors of sodium-glucose cotransporter  type 2 were absent. The similar data were obtained in accordance with HAD scale. Significant difference in the cognitive function indices was only revealed  by the  results of the test «5 words» and the «Schulte test» between group 4 and group 6. No significant difference were observed in other groups during the test.  Conclusions. The deterioration of cognitive function and depressive disorders were established in patients with type 2 diabetes mellitus treated with insulin,  comparing to patients treated with SUD, that may be connected with the better disease compensation, lack of hypoglycemic states, taking adequately matched  hypoglycemic therapy based on metformin, possibly by reducing insulin resistance, recovery of brain signaling and normalization of glucose metabolism, reducing  nerve damage associated with diabetes.