256 research outputs found
Acute hypoglycemia impairs executive cognitive function in adults with and without type 1 diabetes
OBJECTIVE: Acute hypoglycemia impairs cognitive function in several domains. Executive cognitive function governs organization of thoughts, prioritization of tasks, and time management. This study examined the effect of acute hypoglycemia on executive function in adults with and without diabetes. RESEARCH DESIGN AND METHODS: Thirty-two adults with and without type 1 diabetes with no vascular complications or impaired awareness of hypoglycemia were studied. Two hyperinsulinemic glucose clamps were performed at least 2 weeks apart in a single-blind, counterbalanced order, maintaining blood glucose at 4.5 mmol/L (euglycemia) or 2.5 mmol/L (hypoglycemia). Executive functions were assessed with a validated test suite (Delis-Kaplan Executive Function). A general linear model (repeated-measures ANOVA) was used. Glycemic condition (euglycemia or hypoglycemia) was the within-participant factor. Between-participant factors were order of session (euglycemia-hypoglycemia or hypoglycemia-euglycemia), test battery used, and diabetes status (with or without diabetes). RESULTS: Compared with euglycemia, executive functions (with one exception) were significantly impaired during hypoglycemia; lower test scores were recorded with more time required for completion. Large Cohen d values (>0.8) suggest that hypoglycemia induces decrements in aspects of executive function with large effect sizes. In some tests, the performance of participants with diabetes was more impaired than those without diabetes. CONCLUSIONS: Executive cognitive function, which is necessary to carry out many everyday activities, is impaired during hypoglycemia in adults with and without type 1 diabetes. This important aspect of cognition has not received previous systematic study with respect to hypoglycemia. The effect size is large in terms of both accuracy and speed
Distribution and characteristics of newly-defined subgroups of type 2 diabetes in randomised clinical trials : Post hoc cluster assignment analysis of over 12,000 study participants
Publisher Copyright: © 2022Aims: Newly-defined subgroups of type 2 diabetes mellitus (T2DM) have been reported from real-world cohorts but not in detail from randomised clinical trials (RCTs). Methods: T2DM participants, uncontrolled on different pre-study therapies (n = 12.738; 82 % Caucasian; 44 % with diabetes duration > 10 years) from 14 RCTs, were assigned to new subgroups according to age at onset of diabetes, HbA1c, BMI, and fasting C-peptide using the nearest centroid approach. Subgroup distribution, characteristics and influencing factors were analysed. Results: In both, pooled and single RCTs, “mild-obesity related diabetes” predominated (45 %) with mean BMI of 35 kg/m2. “Severe insulin-resistant diabetes” was found least often (4.6 %) and prevalence of “mild age-related diabetes” (23.9 %) was mainly influenced by age at onset of diabetes and age cut-offs. Subgroup characteristics were widely comparable to those from real-world cohorts, but all subgroups showed higher frequencies of diabetes-related complications which were associated with longer diabetes duration. A high proportion of “severe insulin-deficient diabetes” (25.4 %) was identified with poor pre-study glycaemic control. Conclusions: Classification of RCT participants into newly-defined diabetes subgroups revealed the existence of a heterogeneous population of T2DM. For future RCTs, subgroup-based randomisation of T2DM will better define the target population and relevance of the outcomes by avoiding clinical heterogeneity.Peer reviewe
Effects of Acute Insulin-Induced Hypoglycemia on Indices of Inflammation Putative mechanism for aggravating vascular disease in diabetes
OBJECTIVE: To examine the effects of acute insulin-induced hypoglycemia on inflammation, endothelial dysfunction, and platelet activation in adults with and without type 1 diabetes. RESEARCH DESIGN AND METHODS: We studied 16 nondiabetic adults and 16 subjects with type 1 diabetes during euglycemia (blood glucose 4.5 mmol/l) and hypoglycemia (blood glucose 2.5 mmol/l). Markers of inflammation, thrombosis, and endothelial dysfunction (soluble P-selectin, interleukin-6, von Willebrand factor [vWF], tissue plasminogen activator [tPA], high-sensitivity C-reactive protein [hsCRP], and soluble CD40 ligand [sCD40L]) were measured; platelet-monocyte aggregation and CD40 expression on monocytes were determined using flow cytometry. RESULTS: In nondiabetic participants, platelet activation occurred after hypoglycemia, with increments in platelet-monocyte aggregation and P-selectin (P ≤ 0.02). Inflammation was triggered with CD40 expression increasing maximally at 24 h (3.13 ± 2.3% vs. 2.06 ± 1.0%) after hypoglycemia (P = 0.009). Both sCD40L and hsCRP (P = 0.02) increased with a nonsignificant rise in vWF and tPA, indicating a possible endothelial effect. A reduction in sCD40L, tPA, and P-selectin occurred during euglycemia (P = 0.03, P ≤ 0.006, and P = 0.006, respectively). In type 1 diabetes, both CD40 expression (5.54 ± 4.4% vs. 3.65 ± 1.8%; P = 0.006) and plasma sCD40L concentrations increased during hypoglycemia (peak 3.41 ± 3.2 vs. 2.85 ± 2.8 ng/ml; P = 0.03). Platelet-monocyte aggregation also increased significantly at 24 h after hypoglycemia (P = 0.03). A decline in vWF and P-selectin occurred during euglycemia (P ≤ 0.04). CONCLUSIONS: Acute hypoglycemia may provoke upregulation and release of vasoactive substances in adults with and without type 1 diabetes. This may be a putative mechanism for hypoglycemia-induced vascular injury
Distortion of the Local Magnetic Field Appears to Neither Disrupt Nocturnal Navigation nor Cue Shelter Recognition in the Amblypygid \u3ci\u3eParaphrynus laevifrons\u3c/i\u3e
Many arthropods are known to be sensitive to the geomagnetic field and exploit the field to solve spatial problems. The polarity of the geomagnetic field is used, for instance, as an orientation cue by leafcutter ants as they travel on engineered trails in a rainforest and by Drosophila larvae as they move short distances in search of food. A ubiquitous orientation cue like the geomagnetic field may be especially useful in complex, cluttered environments like rainforests, where the reliability of celestial cues used to navigate in more open environments may be poor. The neotropical amblypygid Paraphrynus laevifrons is a nocturnal arachnid that wanders nightly in the vicinity of its shelter and occasionally travels 30 m or more in the rainforest understory before it returns to its shelter. Here, we conducted a field experiment to determine whether navigation by P. laevifrons is guided by the ambient magnetic field and a complementary laboratory experiment to assess whether a magnetic anomaly could be used to pinpoint the entrance of a shelter. In the field experiment, subjects were fitted with a radio transmitter and a small, powerful magnet or a similar-sized brass disk and displaced 10 m from their shelter. The return rate of magnet-fitted subjects was similar to that of brass-fitted subjects and to that of subjects in an earlier study fitted with only a radio transmitter. In the laboratory experiment, we trained P. laevifrons with a protocol under which the amblypygid Phrynus marginemaculatus rapidly learns—in 1–14 trials over two daily sessions—to associate an olfactory stimulus with access to a shelter. The conditioned stimulus here was a magnetic anomaly characterized by a high total field intensity and a 180° reversal of the polarity of the ambient magnetic field. The magnetic anomaly–shelter contingency was not learned in 50 trials conducted over 10 daily sessions. These results imply prima facie that P. laevifrons does not rely on a magnetic compass to locate or recognize a shelter and, perhaps, that the magnetic field cannot be detected, but alternative explanations are discussed
Morning Cortisol Levels and Cognitive Abilities in People With Type 2 Diabetes: The Edinburgh Type 2 Diabetes Study
Effects of Acute Insulin-Induced Hypoglycemia on Spatial Abilities in Adults With Type 1 Diabetes
Prevalence of and Risk Factors for Hepatic Steatosis and Nonalcoholic Fatty Liver Disease in People With Type 2 Diabetes: the Edinburgh Type 2 Diabetes Study
Recognizing Speech in a Novel Accent: The Motor Theory of Speech Perception Reframed
The motor theory of speech perception holds that we perceive the speech of
another in terms of a motor representation of that speech. However, when we
have learned to recognize a foreign accent, it seems plausible that recognition
of a word rarely involves reconstruction of the speech gestures of the speaker
rather than the listener. To better assess the motor theory and this
observation, we proceed in three stages. Part 1 places the motor theory of
speech perception in a larger framework based on our earlier models of the
adaptive formation of mirror neurons for grasping, and for viewing extensions
of that mirror system as part of a larger system for neuro-linguistic
processing, augmented by the present consideration of recognizing speech in a
novel accent. Part 2 then offers a novel computational model of how a listener
comes to understand the speech of someone speaking the listener's native
language with a foreign accent. The core tenet of the model is that the
listener uses hypotheses about the word the speaker is currently uttering to
update probabilities linking the sound produced by the speaker to phonemes in
the native language repertoire of the listener. This, on average, improves the
recognition of later words. This model is neutral regarding the nature of the
representations it uses (motor vs. auditory). It serve as a reference point for
the discussion in Part 3, which proposes a dual-stream neuro-linguistic
architecture to revisits claims for and against the motor theory of speech
perception and the relevance of mirror neurons, and extracts some implications
for the reframing of the motor theory
Association Between Raised Inflammatory Markers and Cognitive Decline in Elderly People With Type 2 Diabetes: The Edinburgh Type 2 Diabetes Study
OBJECTIVE-To determine whether circulating levels of the inflammatory markers C-reactive protein (CRP), interleukin (IL)-6, and tumor necrosis factor (TNF)-alpha are associated with cognitive ability and estimated lifetime cognitive decline in an elderly population with type 2 diabetes. RESEARCH DESIGN AND METHODS-A cross-sectional study of 1,066 men and women aged 60-75 years with type 2 diabetes and living in Lothian, Scotland (the Edinburgh Type 2 Diabetes Study), was performed. Seven cognitive tests were used to measure abilities in memory, nonverbal reasoning, information processing speed, executive function, and mental flexibility. The results were used to derive a general intelligence factor (g). A vocabulary-based test was administered as an estimate of peak prior cognitive ability. Results on the cognitive tests were assessed for statistical association with inflammatory markers measured in a venous blood sample at the time of cognitive testing. RESULTS-Higher IL-6 and TNF-alpha levels were associated with poorer age- and sex-adjusted scores on the majority of the individual cognitive tests. They were also associated with g using standardized regression coefficients -0.074 to -0.173 (P < 0.05). After adjusting for vocabulary, education level, cardiovascular dysfunction, duration of diabetes, and glycemic control, R,6 remained associated with three of the cognitive tests and with g. CONCLUSIONS-In this representative population of people with type 2 diabetes, elevated circulating levels of inflammatory markers were associated with poorer cognitive ability. IL-6 levels were also associated with estimated lifetime cognitive decline. Diabetes 59:710-713, 201
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