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June 2024
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P: Epidemiology—Diabetes Complications| June 14 2024
HETAL SHAH;
HETAL SHAH
Chestnut Hill, MA, Boston, MA, Somerville, MA
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MATTHEW DESALVO;
MATTHEW DESALVO
Chestnut Hill, MA, Boston, MA, Somerville, MA
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ANASTASIA HAIDAR;
ANASTASIA HAIDAR
Chestnut Hill, MA, Boston, MA, Somerville, MA
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SURYA VISHVA TEJA JANGOLLA;
SURYA VISHVA TEJA JANGOLLA
Chestnut Hill, MA, Boston, MA, Somerville, MA
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MARC GREGORY YU;
MARC GREGORY YU
Chestnut Hill, MA, Boston, MA, Somerville, MA
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REBECCA ROQUE;
REBECCA ROQUE
Chestnut Hill, MA, Boston, MA, Somerville, MA
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NOLAN A. ZIEMNIAK;
NOLAN A. ZIEMNIAK
Chestnut Hill, MA, Boston, MA, Somerville, MA
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ELIZABETH R. VIEBRANZ;
ELIZABETH R. VIEBRANZ
Chestnut Hill, MA, Boston, MA, Somerville, MA
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I-HSIEN WU;
I-HSIEN WU
Chestnut Hill, MA, Boston, MA, Somerville, MA
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WARD FICKWEILER;
WARD FICKWEILER
Chestnut Hill, MA, Boston, MA, Somerville, MA
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TANVI CHOKSHI;
TANVI CHOKSHI
Chestnut Hill, MA, Boston, MA, Somerville, MA
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TASHRIF BILLAH;
TASHRIF BILLAH
Chestnut Hill, MA, Boston, MA, Somerville, MA
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LIPENG NING;
LIPENG NING
Chestnut Hill, MA, Boston, MA, Somerville, MA
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ATIF ADAM;
ATIF ADAM
Chestnut Hill, MA, Boston, MA, Somerville, MA
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JENNIFER K. SUN;
JENNIFER K. SUN
Chestnut Hill, MA, Boston, MA, Somerville, MA
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YOGESH RATHI;
YOGESH RATHI
Chestnut Hill, MA, Boston, MA, Somerville, MA
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MEL B. FEANY;
MEL B. FEANY
Chestnut Hill, MA, Boston, MA, Somerville, MA
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GEORGE L. KING
GEORGE L. KING
Chestnut Hill, MA, Boston, MA, Somerville, MA
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Diabetes 2024;73(Supplement_1):1337-P
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Citation
HETAL SHAH, MATTHEW DESALVO, ANASTASIA HAIDAR, SURYA VISHVA TEJA JANGOLLA, MARC GREGORY YU, REBECCA ROQUE, NOLAN A. ZIEMNIAK, ELIZABETH R. VIEBRANZ, I-HSIEN WU, WARD FICKWEILER, TANVI CHOKSHI, TASHRIF BILLAH, LIPENG NING, ATIF ADAM, JENNIFER K. SUN, YOGESH RATHI, MEL B. FEANY, GEORGE L. KING; 1337-P: Improvement of Visual Acuity May Protect against Cognitive Decline and Cortical Atrophy in Long-Duration Type 1 Diabetes. Diabetes 14 June 2024; 73 (Supplement_1): 1337–P. https://doi.org/10.2337/db24-1337-P
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Cognitive decline is a grave complication in aging people with type 1 diabetes (T1D). We previously reported that compared to individuals without diabetes, those with long-duration T1D, the Joslin “Medalists” cohort, have impaired cognitive function, similar to people with type 2 diabetes (T2D). We further reported that Medalists (n=52), with T1D≥50 years, mean age of 71 years, mean HbA1c of 6.8 %, a good lipid profile and controlled hypertension, had significantly lower brain volumes compared to age-matched controls (n=20) on brain MRI (Alzheimer Disease Neuroimaging Initiative-3 protocol), but no significant differences in neurovascular lesions. In this study, we demonstrate that among Medalists, reduced total and regional brain volumes were cross-sectionally associated (p<0.05) with female sex, worse psychom*otor function and visual acuity, longer diabetes duration and higher inflammatory cytokines, but not with glycemic control (HbA1c, continuous glucose monitoring indices, advanced glycation end-products) or history of hypoglycemia. Interestingly, worse cognitive function and lower brain volumes, in addition to diabetic retinopathy, correlated selectively with thinning of the outer retinal nuclear layer (ONL, composed of photoreceptors) as assessed by Optical Coherence Tomography. Mediation analysis showed that psychom*otor function mediated 58 % of the association between visual acuity and brain volume, and 44 % of the association between ONL thickness and brain volume. In a longitudinal subset (n=48), where Medalists had 2 or more cognitive visits with an average follow-up time of 4.8 years between visits, worse baseline visual acuity was associated with decline in psychom*otor function over 3-5 years of follow-up. These findings suggest that future studies should investigate a potentially novel therapeutic approach of targeting improvement in visual acuity to prevent cognitive decline in people with long-duration T1D.
Disclosure
H. Shah: None. M. Desalvo: None. A. Haidar: None. S. Jangolla: None. M. Yu: None. R. Roque: None. N.A. Ziemniak: None. E.R. Viebranz: None. I. Wu: None. W. Fickweiler: None. T. Chokshi: None. T. Billah: None. L. Ning: None. A. Adam: None. J.K. Sun: Research Support; Optovue, Boehringer-Ingelheim, Novo Nordisk, Roche Pharmaceuticals. Other Relationship; Roche Pharmaceuticals. Research Support; Physical Sciences, Inc, Boston Micromachines. Y. Rathi: None. M.B. Feany: None. G.L. King: None.
Funding
NIH/NIDDK (3P30DK036836-34S1); The Beatson Foundation
© 2024 by the American Diabetes Association
2024
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.
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