Evidence mapPaperPMID 38499605Full record

ArticleNPJ digital medicine2024

Dynamic associations between glucose and ecological momentary cognition in Type 1 Diabetes.

Z W Hawks, E D Beck, L Jung, L M Fonseca, M J Sliwinski, R S Weinstock, E Grinspoon, I Xu, R W Strong, S Singh and 11 more

Open access · goldAbstract read
In one paragraph

Article in NPJ digital medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed
7.6field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 19 citations in OpenAlex.

  1. Trial
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  7. Concussion in the Wild: Clinical Utility of Ambulatory Assessment of Symptoms and Everyday Exposures in Adolescents and Adults with Concussion.Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists · 2026
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors at 12 institutions in 2 countries.

Z W HawksInstitute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA. zhawks@mclean.harvard.edu.ORCID http://orcid.org/0000-0002-3796-0289
E D BeckDepartment of Psychology, University of California Davis, Davis, CA, USA.ORCID http://orcid.org/0000-0002-8152-3510
L JungInstitute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA.
L M FonsecaElson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA.ORCID http://orcid.org/0000-0002-2849-0545
M J SliwinskiDepartment of Human Development and Family Studies, Center for Healthy Aging, Pennsylvania State University, State College, PA, USA.
R S WeinstockSUNY Upstate Medical University, Syracuse, NY, USA.ORCID http://orcid.org/0000-0001-5859-5666
E GrinspoonInstitute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA.ORCID http://orcid.org/0000-0002-5608-8254
I XuDepartment of Psychology, University of Notre Dame, Notre Dame, IN, USA.
R W StrongThe Many Brains Project, Belmont, MA, USA.
S SinghInstitute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA.
H P A Van DongenSleep and Performance Research Center & Department of Translational Medicine and Physiology, Washington State University, Spokane, WA, USA.ORCID http://orcid.org/0000-0002-4678-2971
M R FrumkinDepartment of Psychiatry, Harvard Medical School, Boston, MA, USA.ORCID http://orcid.org/0000-0002-3122-4483
J BulgerSUNY Upstate Medical University, Syracuse, NY, USA.
M J ClevelandDepartment of Human Development, Washington State University, Pullman, WA, USA.
K JanessJaeb Center for Health Research, Tampa, FL, USA.
Y C KudvaDivision of Endocrinology, Diabetes and Nutrition, Mayo Clinic, Rochester, MN, USA.ORCID http://orcid.org/0000-0003-0285-6622
R PratleyAdventHealth Translational Research Institute, Orlando, FL, USA.
M R RickelsUniversity of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
S R RizviDivision of Endocrinology, Diabetes and Nutrition, Mayo Clinic, Rochester, MN, USA.ORCID http://orcid.org/0000-0002-2607-4812
N S ChaytorElson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA.ORCID http://orcid.org/0000-0001-8821-289X
L T GermineInstitute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA.
Harvard University · USWashington State University Spokane · USMayo Clinic · USMcLean Hospital · USSUNY Upstate Medical University · USJaeb Center for Health Research · USPennsylvania State University · USTranslational Research Institute for Metabolism and Diabetes · USUniversity of California, Davis · USUniversity of Notre Dame · USUniversity of Pennsylvania · USWashington State University · US

Funding

Institutional Clinical and Translational Science AwardUL1TR001878 · UNIVERSITY OF PENNSYLVANIA · 2025 to 2025
$10.2M
Mobile Measures of Threat Sensitivity for Cross-sectional and Longitudinal AssessmentR01MH121617 · NIMH · MCLEAN HOSPITAL · 2023 to 2025
$2.3M
Advanced Insulin Delivery to Reduce Impaired Awareness of Hypoglycemia in a T1D Cohort (AIDRIAHT1C)U01DK135131 · NIDDK · ADVENTHEALTH ORLANDO · 2024 to 2025
$1.2M
BAT as a therapeutic for the metabolic and cardiac dysfunction with senescence.R01AG060542 · NIA · OHIO STATE UNIVERSITY · PI Paul Martin Coen, Kristin I Stanford · 2023 to 2023
$580k
Continuation of Type 1 Diabetes in Acute Pancreatitis Consortium – UF Health and AdventHealth Combined Clinical CenterU01DK127392 · UNIVERSITY OF FLORIDA · 2025 to 2025
$453k
Alzheimer's Association AARFD-21-851373NCATS NIH HHS UL1 TR001878NIA NIH HHS K99 AG082864NIA NIH HHS R01 AG058883NIA NIH HHS R01 AG060153NIA NIH HHS R01 AG060542NIDDK NIH HHS R01 DK121240NIDDK NIH HHS R01 DK122603NIDDK NIH HHS U01 DK127392NIDDK NIH HHS U01 DK135131NIMH NIH HHS F31 MH124291NIMH NIH HHS F32 MH127812NIMH NIH HHS R01 MH121617
6 · The paper itself

Abstract

Type 1 diabetes (T1D) is a chronic condition characterized by glucose fluctuations. Laboratory studies suggest that cognition is reduced when glucose is very low (hypoglycemia) and very high (hyperglycemia). Until recently, technological limitations prevented researchers from understanding how naturally-occurring glucose fluctuations impact cognitive fluctuations. This study leveraged advances in continuous glucose monitoring (CGM) and cognitive ecological momentary assessment (EMA) to characterize dynamic, within-person associations between glucose and cognition in naturalistic environments. Using CGM and EMA, we obtained intensive longitudinal measurements of glucose and cognition (processing speed, sustained attention) in 200 adults with T1D. First, we used hierarchical Bayesian modeling to estimate dynamic, within-person associations between glucose and cognition. Consistent with laboratory studies, we hypothesized that cognitive performance would be reduced at low and high glucose, reflecting cognitive vulnerability to glucose fluctuations. Second, we used data-driven lasso regression to identify clinical characteristics that predicted individual differences in cognitive vulnerability to glucose fluctuations. Large glucose fluctuations were associated with slower and less accurate processing speed, although slight glucose elevations (relative to person-level means) were associated with faster processing speed. Glucose fluctuations were not related to sustained attention. Seven clinical characteristics predicted individual differences in cognitive vulnerability to glucose fluctuations: age, time in hypoglycemia, lifetime severe hypoglycemic events, microvascular complications, glucose variability, fatigue, and neck circumference. Results establish the impact of glucose on processing speed in naturalistic environments, suggest that minimizing glucose fluctuations is important for optimizing processing speed, and identify several clinical characteristics that may exacerbate cognitive vulnerability to glucose fluctuations.

Identifiers

PMID38499605
PMCPMC10948782
OpenAlexW4392913520

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.