Association of Glycemia, Lipids, and Blood Pressure With Cognitive Performance in People With Type 2 Diabetes in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE)

OBJECTIVE

Type 2 diabetes is a risk factor for cognitive impairment. We examined the relation of glycemia, lipids, blood pressure (BP), hypertension history, and statin use with cognition in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE).

RESEARCH DESIGN AND METHODS

Cross-sectional analyses from GRADE at baseline examined the association of glycemia (hemoglobin A_1c [HbA_1c]), LDL, systolic BP (SBP) and diastolic BP (DBP), hypertension history, and statin use with cognition assessed by the Spanish English Verbal Learning Test, letter and animal fluency tests, and Digit Symbol Substitution Test (DSST).

RESULTS

Among 5,047 GRADE participants, 5,018 (99.4%) completed cognitive assessments. Their mean age was 56.7 ± 10.0 years, and 36.4% were women. Mean diabetes duration was 4.0 ± 2.7 years. HbA_1c was not related to cognition. Higher LDL was related to modestly worse DSST scores, whereas statin use was related to modestly better DSST scores. SBP between 120 and 139 mmHg and DBP between 80 and 89 mmHg were related to modestly better DSST scores. Hypertension history was not related to cognition.

CONCLUSIONS

In people with type 2 diabetes of a mean duration of <5 years, lower LDL and statin use were related to modestly better executive cognitive function. SBP levels in the range of 120-139 mmHg and DBP levels in the range of 80-89 mmHg, but not lower levels, were related to modestly better executive function. These differences may not be clinically significant.

Use of an online personal health record's Track Health function to promote positive lifestyle behaviors in Veterans with prediabetes

This pilot 3-month clinical trial investigated the feasibility, effectiveness, and acceptability of using the Track Health function of the Veterans Health Administration's personal health record for eliciting a more positive physical activity and dietary intake lifestyle in a sample of 38 overweight and obese Veterans with prediabetes. Comparisons between baseline and 3 months post-intervention indicated significant improvements in weight, physical activity, abdominal circumference, and blood pressure. Use of a personal health record that users can identify with and find usable and useful coupled with instruction targeting critical functionalities could potentially promote healthy behavioral lifestyle changes.

Filariasis in Colombia: prevalence of Mansonella ozzardi in the Departamento de Meta, Intendencia del Casanare, and Comisaría del Vichada

The prevalence and distribution of filarial infections among the inhabitants of adjacent regions of the Departamento del Meta, Intendencia del Casanare, and Comisaría del Vichada in northeastern Colombia was determined by collection and examination of blood samples using the Knott's method. Mansonella ozzardi, the only species detected, was found in 2.5% of the samples collected in Meta (6/243), in 4.9% from Casanare (12/247) and in 2.5% from Vichada (3/137). All of the microfilaria carriers were Indians who had migrated from other parts of eastern Colombia, principally from the interior of Meta and Vichada. These results indicate that filariases are not endemic in the regions examined, and suggest that influx of microfilaria carriers with sufficiently high microfilaremia could establish new foci of transmission in areas where appropriate vectors are abundant.