Sleep quality, metabolism, cognitive function, autonomic nervous system

Research related to lifestyle-related diseases and cardiovascular risk factors

This study is a multicenter cohort study targeting patients with risk factors for arteriosclerosis, including diabetes patients, with the aim of clarifying factors related to the onset and progression of cognitive impairment and arteriosclerosis. Since its inception in 2018, 516 patients have been enrolled as of March 2023, and new enrollments and follow-up are currently being conducted in parallel. In this study, we are evaluating blood glucose fluctuations using a continuous glucose monitor (CGM), objectively evaluating sleep status using an accelerometer, evaluating the intestinal flora and its metabolic products, and evaluating cognitive function scores and brain image markers such as head MRI, and are conducting follow-up studies on the interrelationships between these.
So far, we have reported that 1) diabetes duration and diabetic complications are associated with a worsening of CGM-derived glycemic control indices, and 2) the use of diabetes medications with hypoglycemic risk in elderly people increases the risk of worsening CGM-derived hypoglycemic indices (related paper 1). We also reported that the impact of carbohydrate intake in diabetic patients on CGM-derived glycemic control indices and arteriosclerosis indices is limited (related paper 2). Furthermore, by integrated analysis with a type 1 diabetes cohort, we clarified the association between HbA1c, glycated albumin, and CGM-derived glycemic control indices (related paper 3).
In the future, we plan to clarify the interrelationships between blood sugar fluctuations, sleep disorders, and cognitive impairment, and hope to find targets for preventing cognitive decline.

It is assumed that deterioration of glycemic control, sleep disorders, and cognitive impairment have a negative effect on each other, but there are few prospective studies that focus on this interrelationship.

This study is original in that it comprehensively evaluates and tracks blood glucose fluctuations, sleep quality, cognitive impairment, and atherosclerotic disease.

It has been reported that sleep disorders are associated not only with diabetes and arteriosclerotic diseases, but also with cognitive impairment, and countermeasures against these disorders are a challenge.
It is hoped that this research will lead to the discovery of new target molecules related to the prevention and diagnosis of cognitive decline.

Similar analyses can be performed in patients without diabetes.
Sub-analyses include analysis of predictive factors such as brain volume, ischemia, cerebral blood flow, and amyloid accumulation.

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1. Kuroda N, et al. J Diabetes Investig. 2021, 12: 244-253
2. Osugi K et al: J Diabetes Investig. 2023, 14: 659-668
3. Ohigashi M et al: J Diabetes Investig. 2021, 12:940-949