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Published online May 1, 2007
Diabetes Care 30:2001-2002, 2007
DOI: 10.2337/dc06-2480
© 2007 by the American Diabetes Association
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Clinical Care/Education/Nutrition/Psychosocial Research
Original Article

Effects of Blood Glucose Rate of Changes on Perceived Mood and Cognitive Symptoms in Insulin-Treated Type 2 Diabetes

Daniel J. Cox, PHD1, Anthony McCall, MD, PHD1, Boris Kovatchev, PHD1, Samiha Sarwat, MS2, Liza L. Ilag, MD2 and Meng H. Tan, MD2

1 University of Virginia Health Sciences Center, Charlottesville, Virginia
2 Eli Lilly and Company, Indianapolis, Indiana

Address correspondence and reprint requests to Dr. Daniel J. Cox, Psychiatry and Neurobehavioral Sciences, University of Virginia Health Sciences Center, Charlottesville, VA. E-mail: djc4f@virginia.edu

Abbreviations: BDI-II, Beck Depression Inventory II • BGRATE, blood glucose rate of change

The first 20% of the full text of this article appears below.


   INTRODUCTION
 
Studies indicate that diabetes affects mood, cognitive function, and motor performance (1–5). As cognitive dysfunction and depressive mood symptoms have been reported with hyperglycemia (5–7), we hypothesized that the impact of insulin on blood glucose parameters would affect mood and cognitive symptoms. Consistent with our past post hoc findings (7), we specifically hypothesized that rapid pre- to postmeal blood glucose rate of change (BGRATE) correlates with negative mood and cognitive postmeal symptoms but not with energy or positive mood. We report the results of correlation analyses of BGRATE with symptoms from a pilot investigation designed to evaluate whether improvements in glycemic control seen with basal plus prandial insulin analog regimens compared with basal insulin analog in patients with type 2 diabetes (8–10) would lead to measurable mood and cognitive differences.


   RESEARCH DESIGN AND METHODS—
 
A single-center, open-label, crossover, randomized, controlled clinical trial enrolled 60 adults with type 2 diabetes, A1C 7–10%, and prestudy use of metformin (with or without oral antihyperglycemic medications or once daily insulin). Pregnant or breast-feeding women and patients with a previous diagnosis of depression or treated with centrally acting medications (e.g., antidepressants or anxiolytics) were excluded.

Patients . . . [Full Text of this Article]


   RESULTS—
 

   CONCLUSIONS—
 

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