Aims: Aim of the study was to investigate cognitive performance in elderly with type 1 diabetes (T1DM) on insulin pump (CSII) and the correlation between time in range (TIR) and cognitive scores (CS) . Differences in CS according to duration of disease were also investigated.
Methods: Subjects with T1DM older than 65 years, on CSII were included. Participants underwent following tests: Rey Auditory Verbal Learning Test (RAVLT) , Rey-Osterrieth Figure Test, Verbal Fluency Test, Stroop Color and Word Test and Trail Making Test (TMT) A and B. At visit data from continuous glucose monitoring, according to 20Advanced Technology and Treatments in Diabetes Consensus, data on diabetic history and blood tests were collected.
Results: We enrolled 45 subjects, 22 women (49%) , mean age 69.5 years. Median duration of disease was 30 years; mean HbA1c was 58 mmol/mol (7.4%) . Mean TIR was 66%, mean time below range was 2.62% and time above range (TAR) 29.9%. 5 subjects (11%) presented CS compatible with mild cognitive impairment. No correlation between TIR and CS was detected. Dividing study population on median duration of disease, subjects with longer history presented lower TIR (59.7 % (20.2) vs. 71.1% (16.3) , p=0.05) and higher TAR (35.7% (17.8) vs. 25.2% (15.3) , p=0.05) . In both groups 26% were using advanced hybrid closed loop systems. Subjects with longer history presented lower scores at RAVLT-Immediate recall (30.1 (12.6) vs. 39.3 (13.4) , p<0.001) and RAVLT-Accuracy (0.89 (0.09) vs. 0.93 (0.05) , p=0.08) and longer time at Stroop-Test (28.8 (8.13) vs. 20.0 (7.36) , p<0.001) and TMT-B (131 (64.2) vs. 1 (32.2) , p=0.08) test. Groups were comparable for school age (>30 years 12.9 vs. <30 years 13.1, p=0.80) .
Conclusions: Elderly with T1DM presented good TIR and at, a deep evaluation, they presented good CS. Those with longer history presented lower CS in executive and attentive functions, expression of cerebral subcortical damage. No association between TIR and CS was detected.
A.Rizzi: None. D.Pitocco: None. D.Quaranta: None. F.L'abbate: None. G.Masoneiacobucci: None. L.Tartaglione: None. L.Leo: None. G.Rizzo: None. C.Marra: None. G.Desideri: None.