| Summary: | MMed, Internal Medicine, Faculty of Health Sciences,University of the Witwatersrand === Aims: To determine whether impairment of the executive functioning domain of cognition
could be detected by a battery of simple bedside cognitive tests of executive function
associated with inadequate glycaemic control.
Methods: People with type 2 diabetes attending a tertiary referral diabetic clinic who
consented to participate in the study underwent a brief battery of cognitive testing (the
Bedside Executive Screening Test) designed to detect executive function impairment.
Glycaemic control was determined using glycated haemoglobin levels (HbA1c). Inadequate
glycaemic control was defined as HbA1c ≥ 7.0%.
Results: Executive function impairment was detected in 51 (52%) of the 98 study
participants. The presence of executive function impairment was significantly associated
with poor glycaemic control (HbA1c ≥ 7.0%) (odds ratio 4.9, 95% confidence interval 1.3 –
18.8, p=0.019). There were no significant differences between patients with and without
executive function impairment with regard to age, target organ damage, patient reported
adherence, and hypoglycaemic therapy. Patients with a lower level of education were more
likely to demonstrate executive impairment when glycaemic control was poor (p=0.013).
Conclusion: Executive function impairment is common in a population of people with
difficult-to-manage type 2 diabetes. The presence of executive impairment is significantly
associated with poor glycaemic control.
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