ArticleThe Journal of clinical endocrinology and metabolism2021
The Relationship Between Glucose Control and Cognitive Function in People With Diabetes After a Lacunar Stroke.
Article in The Journal of clinical endocrinology and metabolism, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00059306 (Secondary Prevention of Small Subcortical Strokes), which is not on this map. Cited by 9 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Secondary Prevention of Small Subcortical Strokes (SPS3) Trial
Who cites it
9 citing papers in PubMed, 17 citations in OpenAlex.
- A technology-blended exercise intervention for cognitive risk reduction and brain health in middle-aged and older adults with type 2 diabetes in Singapore: a mixed-methods study.The journals of gerontology. Series A, Biological sciences and medical sciences · 2026Trial
- Application of diffusion tensor imaging analysis along perivascular spaces in evaluating glymphatic system function in type 2 diabetes mellitus.Frontiers in neuroscience · 2026Article
- Novel Insights into the Mechanism and Treatment of Diabetes-Related Brain Complications: Focusing on the Blood-Brain Barrier Impairment.Aging and disease · 2025Review
- The enlarged perivascular spaces in the hippocampus is associated with memory function in patients with type 2 diabetes mellitus.Scientific reports · 2025Article
- Enlarged perivascular spaces in the basal ganglia mediate the negative impact of HbA1c levels on mild cognitive impairment.Frontiers in human neuroscience · 2025Article
- Molecular Hydrogen Mediates Neurorestorative Effects After Stroke in Diabetic Rats: the TLR4/NF-κB Inflammatory Pathway.Journal of neuroimmune pharmacology : the official journal of the Society on NeuroImmune Pharmacology · 2023Article
- Relationship between cognitive function in individuals with diabetic foot ulcer and mortality.Diabetology & metabolic syndrome · 2022Article
- High serum amyloid A predicts risk of cognitive impairment after lacunar infarction: Development and validation of a nomogram.Frontiers in neurology · 2022Article
- Novel Targets and Interventions for Cognitive Complications of Diabetes.Frontiers in physiology · 2021Review
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 3 countries.
Funding
Abstract
contextLacunar strokes and diabetes are risk factors for cognitive dysfunction. Elucidating modifiable risk factors for cognitive dysfunction has great public health implications. One factor may be glycemic status, as measured by glycated hemoglobin (A1c).
objectiveThe aim of this study was to assess the relationship between A1c and cognitive function in lacunar stroke patients with diabetes.
methodsThe effect of baseline and follow-up A1c on the baseline and the change in Cognitive Assessment Screening Instrument (CASI) score over time among participants with a median of 2 cognitive assessments (range, 1-5) was examined in 942 individuals with diabetes and a lacunar stroke who participated in the Secondary Prevention of Small Subcortical Strokes (SPS3) trial (ClinicalTrials.gov No. NCT00059306).
resultsEvery 1% higher baseline A1c was associated with a 0.06 lower standardized CASI z score (95% CI, -0.101 to -0.018). Higher baseline A1c values were associated with lower CASI z scores over time (P for interaction = .037). A 1% increase in A1c over time corresponded with a CASI score decrease of 0.021 (95% CI, -0.0043 to -0.038) during follow-up. All these remained statistically significant after adjustment for age, sex, education, race, depression, hypertension, hyperlipidemia, body mass index, cardiovascular disease, obstructive sleep apnea, diabetic retinopathy, nephropathy insulin use, and white-matter abnormalities.
conclusionThis analysis of lacunar stroke patients with diabetes demonstrates a relationship between A1c and change in cognitive scores over time. Intervention studies are needed to delineate whether better glucose control could slow the rate of cognitive decline in this high-risk population.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.