Insulin resistance and cognitive performance in type 2 diabetes - The Maastricht study

Stefan L. C. Geijselaers*, Simone J. S. Sep, Miranda T. Schram, Martin P. J. van Boxtel, Ronald M. A. Henry, Frans R. J. Verhey, Abraham A. Kroon, Nicolaas C. Schaper, Pieter C. Dagnelie, Carla J. H. van der Kallen, Coen D. A. Stehouwer, Geert Jan Biessels

*Corresponding author for this work

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Aims: Type 2 diabetes, hyperinsulinemia, and insulin resistance are associated with cognitive impairment. Experimental studies indicate that insulin signaling in the brain is related to cognitive performance. Here we evaluated whether insulin-related variables contribute to the variance in cognitive performance among individuals with type 2 diabetes. Methods: A total of 806 individuals with type 2 diabetes (mean age 62 +/- 8 years, HbAlc 6.9 +/- 1.1%) completed a neuropsychological test battery. Insulin-related variables evaluated were: fasting plasma insulin, C-peptide, and the Homeostasis Model Assessment (HOMA2-IR; in individuals without insulin treatment; n = 641). The unadjusted coefficient of determination (R-2), obtained from multiple linear regression analyses, was used to estimate the proportion of variance in cognition explained by insulin-related variables. Results: Sex, age, and educational level together explained 18.0% (R-2) of the variance in memory function, 26.5% in information processing speed, and 22.8% in executive function and attention. Fasting insulin, C-peptide, or HOMA2-IR did not increase the explained variance (maximum Delta R-2 0.3%, P >= 0.14). Similar results were obtained when insulin-related variables were added to models that additionally included glycemic control, cardiovascular risk factors, and depression. Conclusions: Our results show that measures of peripheral insulin resistance are unrelated to cognitive performance among individuals with adequately controlled type 2 diabetes.
Original languageEnglish
Pages (from-to)824-830
JournalJournal of Diabetes and Its Complications
Issue number5
Publication statusPublished - May 2017


  • Type 2 diabetes mellitus
  • Cognitive performance
  • Fasting insulin
  • C-peptide
  • Insulin resistance


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