Fatigue and cognitive symptoms in patients with diabetes: relationship with disease phenotype and insulin treatment.
Psychoneuroendocrinology. 2012-09-01; 37(9): 1468-1478
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1. Psychoneuroendocrinology. 2012 Sep;37(9):1468-78. doi:
10.1016/j.psyneuen.2012.01.016. Epub 2012 Feb 26.
Fatigue and cognitive symptoms in patients with diabetes: relationship with
disease phenotype and insulin treatment.
Lasselin J(1), Layé S, Barreau JB, Rivet A, Dulucq MJ, Gin H, Capuron L.
(1)INRA, Nutrition and Integrative Neurobiology-NutriNeuro, UMR 1286, F-33076
Neurobehavioral symptoms are frequently reported in patients with diabetes.
Nevertheless, the characterization of the specific symptom dimensions that
develop in diabetic patients with respect to disease phenotype and treatment
status remains obscure. This study comparatively assessed fatigue symptoms and
cognitive performance using a dimensional approach in 21 patients with
insulin-treated type 1 diabetes, 24 type 2 diabetic patients either insulin-free
or undergoing insulin treatment for at least six months, and 15 healthy subjects.
Specific dimensions of fatigue were assessed using the
Multidimensional-Fatigue-Inventory (MFI). Cognitive performance on tests of
choice reaction time, pattern recognition memory and spatial planning was
evaluated using the Cambridge-Neuropsychological-Automated-Battery (CANTAB). Body
mass index (BMI) and glycated-hemoglobin (HbA1C) concentrations were collected,
as well as information on diabetes complications and disease duration. Patients
with type 2 diabetes, regardless of insulin treatment status, exhibited higher
scores of fatigue, primarily in the dimensions of general and physical fatigue as
well as reduced activity. Cognitive alterations, in the form of longer reaction
times and impaired spatial planning, were also detected in type 2 diabetic
patients treated with insulin. These alterations were overall unrelated to
glucose control, as reflected in HbA1C levels, and were not explained by
complications and duration of diabetes. No specific alteration was measured in
type 1 diabetic patients who exhibited fatigue scores and cognitive performance
comparable to healthy participants. While associated with fatigue, increased BMI
did not significantly account for the relationship of type 2 diabetes with
general fatigue and physical fatigue. BMI, however, modulated the association of
type 2 diabetes with reduced activity and the association of insulin-treated type
2 diabetes with psychomotor slowing. These findings reveal specific fatigue and
cognitive symptoms in patients with type 2 diabetes and suggest the involvement
of differential pathophysiological processes.
Copyright © 2012 Elsevier Ltd. All rights reserved.
PMID: 22370460 [Indexed for MEDLINE]