Effects of self-control training in patients with type 2 diabetes based on obesity and cognitive impairments

Abstract

The progressive aging of the population is accompanied by an increase in the prevalence of cognitive impairment (CI). Numerous studies indicate that patients with diabetes mellitus (DM) have a significantly higher risk of CI than healthy individuals. Cognitive dysfunction significantly complicates patients’ ability to selfcontrol, increasing the risk of hypoglycaemia and complications. The aim. To evaluate the effects of training in the basics of selfcontrol in patients with type 2 diabetes (T2D) on the background of obesity and CI. Material and methods. We examined 140 patients with T2D aged 25–60 years. Based on cognitive screening using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA), patients were divided into subgroups according to the presence of CI and receiving training on the basics of diabetes self-controlling. Results. More than 57% had mild or moderate CI among the examined patients. In the subgroups that received training in the basics of diabetes self-management, there was a significant improvement in glycaemic control and cognitive functions (MMSE scale +1.03±0.16; MoCA test+0.69±0.12, p<0.001) and a decrease in the levels of anxiety and depression levels according to the Hospital Anxiety and Depression Scale (HADS), and the Beck Depression Inventory (p<0.05). An inverse correlation was established between the level of glycated haemoglobin (HbA1c)
and CI indicators according to the MMSE scale (r=−0.25; p<0.01), as well as positive associations between HbA1c and body mass index (BMI) (r=0.23; p<0.01) anxiety/depression indicators (r=0.35;p<0.001 and r=0.30; p<0.001, respectively), which indicates a frequent combination of anxiety and depressive symptoms in patients with DM2. Conclusions. Cognitive dysfunction is a common complication of T2D, leading to impaired daily activities, self-control, and decreased working capacity of patients. Training in the basics of self-management for patients with T2D helps improve glycemic control, as well as cognitive and psychoemotional states. Educational interventions are an effective tool for preventing the progression of CI in this category of patients.