Cognitive function and risks of cardiovascular disease and hypoglycaemia in patients with type 2 diabetes: the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial
B.E. de Galan,Sophia Zoungas,Sophia Zoungas,John Chalmers,Craig S. Anderson,Carole Dufouil,Carole Dufouil,Avinesh Pillai,M. E. Cooper,Diederik E. Grobbee,Maree L. Hackett,Pavel Hamet,Simon Heller,Liu Lisheng,Stephen MacMahon,Giuseppe Mancia,Bruce Neal,C. Y. Pan,Anushka Patel,Neil R Poulter,F. Travert,Mark Woodward,Mark Woodward +22 more
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TLDR
Cognitive dysfunction is an independent predictor of clinical outcomes in patients with type 2 diabetes, but does not modify the effects of BP lowering or glucose control on the risks of major cardiovascular events.Abstract:
Aims/hypothesis
The relationship between cognitive function, cardiovascular disease and premature death is not well established in patients with type 2 diabetes. We assessed the effects of cognitive function in 11,140 patients with type 2 diabetes who participated in the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial. Furthermore, we tested whether level of cognitive function altered the beneficial effects of the BP-lowering and glycaemic-control regimens in the trial.read more
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Vascular Contributions to Cognitive Impairment and Dementia A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association
Philip B. Gorelick,Angelo Scuteri,Sandra E. Black,Charles DeCarli,Steven M. Greenberg,Costantino Iadecola,Lenore J. Launer,Stéphane Laurent,Oscar L. Lopez,David L. Nyenhuis,Ronald C. Petersen,Julie A. Schneider,Christophe Tzourio,Donna K. Arnett,David A. Bennett,Helena C. Chui,Randall T. Higashida,Ruth Lindquist,Peter M. Nilsson,Gustavo C. Román,Frank W. Sellke,Sudha Seshadri +21 more
TL;DR: This scientific statement provides an overview of the evidence on vascular contributions to cognitive impairment and dementia and provides evidence that subcortical forms of VCI with white matter hyperintensities and small deep infarcts are common and risk markers for VCI are the same as traditional risk factors for stroke.
Canadian Diabetes Association Clinical Practice Guidelines Expert Committee
TL;DR: In patients with marked hyperglycemia (A1C 8.5%), antihyperglycemic agents should be initiated concomitantly with lifestyle management, and consideration should be given to initiating combination therapy with 2 agents, 1 of which may be insulin.
Journal ArticleDOI
Cognitive decline and dementia in diabetes mellitus: mechanisms and clinical implications.
Geert Jan Biessels,Florin Despa +1 more
TL;DR: The evolving insights from studies on risk factors, brain imaging and neuropathology are reviewed, which provide important clues on mechanisms of both the subtle cognitive decrements and the more severe stages of cognitive dysfunction.
Journal ArticleDOI
Diabetic nephropathy - complications and treatment.
TL;DR: This review will examine the current concepts of diabetic nephropathy management in the context of some of the basic science and pathophysiology aspects relevant to the approaches taken in novel, investigative treatment strategies.
Journal ArticleDOI
Dementia and cognitive decline in type 2 diabetes and prediabetic stages: towards targeted interventions
Geert Jan Biessels,Mark W. J. Strachan,Frank L.J. Visseren,L. Jaap Kappelle,Rachel A. Whitmer +4 more
TL;DR: Possible opportunities for intervention to improve cognitive outcomes in people with type 2 diabetes are identified, and how treatment can be tailored to individual risk profiles and comorbidities is suggested.
References
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“Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician
Marshal F. Folstein,Marshal F. Folstein,Susan E B Folstein,Susan E B Folstein,Paul R. McHugh,Paul R. McHugh +5 more
TL;DR: A simplified, scored form of the cognitive mental status examination, the “Mini-Mental State” (MMS) which includes eleven questions, requires only 5-10 min to administer, and is therefore practical to use serially and routinely.
A practical method for grading the cognitive state of patients for the clinician
TL;DR: The Mini-Mental State (MMS) as mentioned in this paper is a simplified version of the standard WAIS with eleven questions and requires only 5-10 min to administer, and is therefore practical to use serially and routinely.
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TL;DR: A strategy of intensive glucose control, involving gliclazide (modified release) and other drugs as required, that lowered the glycated hemoglobin value to 6.5% yielded a 10% relative reduction in the combined outcome of major macrovascular and microvascular events, primarily as a consequence of a 21%relative reduction in nephropathy.
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Cleusa P. Ferri,Martin Prince,Carol Brayne,Henry Brodaty,Laura Fratiglioni,Mary Ganguli,Kathleen S. Hall,Kazuo Hasegawa,Hugh C. Hendrie,Yueqin Huang,Anthony F. Jorm,Colin Mathers,Paulo Rossi Menezes,Elizabeth Rimmer,Marcia Scazufca +14 more
TL;DR: Detailed estimates of dementia prevalence for each world region are believed to constitute the best currently available basis for policymaking, planning, and allocation of health and welfare resources.
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