Evidence map›Paper›PMID 35876660›Full record

ArticleDiabetes care2022

Consistent Effects of Hypoglycemia on Cognitive Function in People With or Without Diabetes.

Clementine E M Verhulst, Therese W Fabricius, Giesje Nefs, Roy P C Kessels, Frans Pouwer, Steven Teerenstra, Cees J Tack, Melanie M Broadley, Peter L Kristensen, Rory J McCrimmon and 4 more

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Article in Diabetes care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Clementine E M VerhulstDepartment of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.ORCID 0000-0002-9905-7669
Therese W FabriciusDepartment of Endocrinology and Nephrology, Nordsjællands Hospital, Hillerød, Denmark.
Giesje NefsDepartment of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.
Roy P C KesselsDonders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands.
Frans PouwerDepartment of Psychology, University of Southern Denmark, Odense, Denmark.ORCID 0000-0002-8172-9818
Steven TeerenstraBiostatistics, Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.
Cees J TackDepartment of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.ORCID 0000-0003-0322-1653
Melanie M BroadleyDepartment of Psychology, University of Southern Denmark, Odense, Denmark.
Peter L KristensenDepartment of Endocrinology and Nephrology, Nordsjællands Hospital, Hillerød, Denmark.
Rory J McCrimmonSchool of Medicine, University of Dundee, Dundee, Scotland.ORCID 0000-0002-3957-1981
Simon HellerDepartment of Oncology and Metabolism, University of Sheffield, Sheffield, U.K.ORCID 0000-0002-2425-9565
Mark L EvansWellcome Trust/MRC Institute of Metabolic Science, University of Cambridge, Cambridge, U.K.
Ulrik Pedersen-BjergaardDepartment of Endocrinology and Nephrology, Nordsjællands Hospital, Hillerød, Denmark.ORCID 0000-0003-0588-4880
Bastiaan E de GalanDepartment of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.ORCID 0000-0002-1255-7741

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveHypoglycemia poses an immediate threat for cognitive function. Due to its association with acute cognitive impairment, the International Hypoglycemia Study Group (IHSG) defines a blood glucose level <3.0 mmol/L as "level 2 hypoglycemia." In the current study we investigated whether having diabetes, type of diabetes, or hypoglycemia awareness moderates this association. RESEARCH DESIGN AND

methodsAdults with type 1 diabetes with normal (n = 26) or impaired (n = 21) hypoglycemic awareness or with insulin-treated type 2 diabetes (n = 15) and age-matched control subjects without diabetes (n = 32) underwent a hyperinsulinemic-euglycemic-hypoglycemic glucose clamp (2.80 ± 0.13 mmol/L [50.2 ± 2.3 mg/dL]). At baseline and during hypoglycemia, calculation ability, attention, working memory and cognitive flexibility were measured with the Paced Auditory Serial Addition Test (PASAT) and the Test of Attentional Performance (TAP).

resultsFor the whole group, hypoglycemia decreased the mean ± SD proportion of correct answers on the PASAT by 8.4 ± 12.8%, increased reaction time on the TAP Alertness task by 32.1 ± 66.6 ms, and increased the sum of errors and omissions on the TAP Working Memory task by 2.0 ± 5.5 (all P < 0.001). Hypoglycemia-induced cognitive declines were largely irrespective of the presence or type of diabetes, level of symptomatic awareness, diabetes duration, or HbA1c.

conclusionsIHSG level 2 hypoglycemia impairs cognitive function in people with and without diabetes, irrespective of type of diabetes or hypoglycemia awareness status. These findings support the cutoff value of hypoglycemia <3.0 mmol/L (<54 mg/dL) as being clinically relevant for most people with diabetes.

Indexed as

Diabetes Mellitus, Type 2HypoglycemiaAdultBlood GlucoseCognitionHumansHypoglycemic AgentsInsulinBlood GlucoseHypoglycemic AgentsInsulin

Identifiers

PMID35876660
PMCPMC9472511

What OpenQuestion holds

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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.