{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:41:58Z","timestamp":1792190518649,"version":"4.4.0"},"reference-count":29,"publisher":"Georg Thieme Verlag KG","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Exp Clin Endocrinol Diabetes"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Mild cognitive impairment may occur early in type 2 diabetes mellitus, but\ndata on its prevalence and longitudinal dynamics in newly diagnosed patients\nwithout overt vascular complications remain limited.<\/jats:p>\n                  <jats:p>We prospectively followed 937 adults with newly diagnosed type 2 diabetes\nmellitus without baseline microvascular or macrovascular complications for a\nmean of 62.7\u00b121.5 months. Cognitive status was assessed using the Montreal\nCognitive Assessment, and mild cognitive impairment was defined as Montreal\nCognitive Assessment-defined cognitive impairment. We evaluated the\nprevalence of mild cognitive impairment at diagnosis, the rate of\nmild cognitive impairment remission among patients with baseline mild\ncognitive impairment, and the incidence of mild cognitive impairment among\ncognitively normal patients. Multivariable models were used to identify\nclinical correlates of these outcomes.<\/jats:p>\n                  <jats:p>At baseline, 286 patients (30.5%) had mild cognitive impairment. During the\nfollow-up, 43\/286 patients (15.0%) experienced remission, whereas 96\/651\ncognitively normal patients (14.7%) developed incident mild cognitive\nimpairment. Higher C-peptide was strongly associated with prevalent mild\ncognitive impairment, and continuous C-peptide remained significantly\nassociated with Montreal Cognitive Assessment performance in multivariable\nanalyses. Smoking was associated with a less favorable cognitive profile,\nuric acid showed an inverse association with prevalent mild cognitive\nimpairment, and participation in therapeutic patient education was\nindependently associated with a lower risk of incident mild cognitive\nimpairment. Incident retinopathy was also associated with incident mild\ncognitive impairment.<\/jats:p>\n                  <jats:p>In newly diagnosed, complication-free type 2 diabetes mellitus, mild\ncognitive impairment defined by Montreal Cognitive Assessment is common and\nclinically dynamic. Our findings suggest that metabolic, behavioral,\neducational, and microvascular factors are associated with cognitive\noutcomes, but they should be interpreted as observational and\nhypothesis-generating rather than as evidence for immediate clinical risk\nstratification.<\/jats:p>","DOI":"10.1055\/a-2893-3900","type":"journal-article","created":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:10:43Z","timestamp":1783123843000},"page":"344-352","source":"Crossref","is-referenced-by-count":0,"title":["Mild Cognitive Impairment in Newly Diagnosed Type 2 Diabetes\n        without Microvascular or Macrovascular Complications:\n        Prevalence, Dynamics, and Clinical Predictors"],"prefix":"10.1055","volume":"134","author":[{"given":"Adriana","family":"Coppola","sequence":"additional","affiliation":[{"name":"Istituto Clinico Beato Matteo, Lombardy, Italy","place":["Vigevano"],"department":["Diabetes and endocrine-metabolic Diseases Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmelo","family":"Pujia","sequence":"additional","affiliation":[{"name":"Magna Graecia University of Catanzaro, Calabria, Italy","place":["Catanzaro"],"department":["Department of Experimental and Clinical Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Castagna","sequence":"additional","affiliation":[{"name":"Magna Graecia University of Catanzaro, Calabria, Italy","place":["Catanzaro"],"department":["Department of Experimental and Clinical Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Gallotti","sequence":"additional","affiliation":[{"name":"Istituto Clinico Beato Matteo, Lombardy, Italy","place":["Vigevano"],"department":["Diabetes and endocrine-metabolic Diseases Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colomba","family":"Falcone","sequence":"additional","affiliation":[{"name":"University of Pavia, Lombardia, Italy","place":["Pavia"],"department":["Centre of Molecular Medicine for the diagnosis and treatment of\ncardiovascular and metabolic diseases (CIRMC)"]},{"name":"Istituto di Cura Citta di Pavia, Lombardia, Italy","place":["Pavia"],"department":["Cardiology Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9974-0735","authenticated-orcid":false,"given":"Carmine","family":"Gazzaruso","sequence":"additional","affiliation":[{"name":"University of Milan, Italy","place":["Vigevano"],"department":["Department of Biomedical Sciences for Health"]},{"name":"Istituto Clinico Beato Matteo, Lombardy, Italy","place":["Vigevano"],"department":["Diabetes and endocrine-metabolic Diseases Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"ref1","volume-title":"IDF Diabetes Atlas","author":"International Diabetes Federation","year":"2021"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1038\/s41574-018-0048-7","article-title":"Cognitive decline and dementia in diabetes mellitus: mechanisms and clinical\nimplications","volume":"14","author":"G J Biessels","journal-title":"Nat Rev Endocrinol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"1617248","DOI":"10.3389\/fendo.2025.1617248","article-title":"Risk factors for mild cognitive impairment in\ntype 2 diabetes: A systematic review and meta-analysis","volume":"16","author":"Y Zhao","year":"2025","journal-title":"Front\nEndocrinol (Lausanne)"},{"issue":"05","key":"ref4","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1111\/j.1445-5994.2012.02758.x","article-title":"Diabetes as a risk factor for dementia and mild cognitive impairment: A\nmeta-analysis of longitudinal studies","volume":"42","author":"G Cheng","year":"2012","journal-title":"Intern Med J"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"e35557","DOI":"10.1097\/MD.0000000000035557","article-title":"The impact of diabetes in cognitive impairment: A review of current evidence and\nprospects for future investigations","volume":"102","author":"N Aderinto","year":"2023","journal-title":"Medicine (Baltimore)"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"e70123","DOI":"10.1111\/dme.70123","article-title":"Associations of glycaemia-related risk factors with dementia and cognitive\ndecline in individuals with type 2 diabetes: A systematic review and\nmeta-analysis","volume":"42","author":"M Tabesh","year":"2025","journal-title":"Diabet Med"},{"issue":"09","key":"ref7","doi-asserted-by":"crossref","first-page":"e0332442","DOI":"10.1371\/journal.pone.0332442","article-title":"Diabetic retinopathy as the primary predictor\nof mild cognitive impairment in type 2 diabetes: Insights from machine learning\nmodels","volume":"20","author":"F Z Rhmari Tlem\u00e7ani","year":"2025","journal-title":"PLoS One"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"1224418","DOI":"10.3389\/fendo.2023.1224418","article-title":"In vivo retinal imaging is associated with\ncognitive decline, blood-brain barrier disruption and neuroinflammation in type\n2 diabetic mice","volume":"14","author":"M Majimbi","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"692911","DOI":"10.3389\/fnagi.2021.692911","article-title":"Association between diabetic retinopathy and cognitive impairment: A systematic\nreview and meta-analysis","volume":"13","author":"D Cheng","year":"2021","journal-title":"Front Aging Neurosci"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.2147\/NDT.S521296","article-title":"Blood uric acid in mild cognitive impairment: A cross-sectional study of older\nchinese adults","volume":"21","author":"L Xue","year":"2025","journal-title":"Neuropsychiatr Dis Treat"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1007\/s42000-023-00465-3","article-title":"Uric acid index is a risk for mild cognitive impairment in type 2 diabetes","volume":"22","author":"X W Tong","year":"2023","journal-title":"Hormones (Athens)"},{"key":"ref12","first-page":"afac173","article-title":"Worldwide prevalence of mild cognitive\nimpairment among community dwellers aged 50 years and older: A meta-analysis and\nsystematic review of epidemiology studies","volume":"51","author":"W Bai","year":"2022","journal-title":"Age\nAgeing"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1177\/0145721720930959","article-title":"Diabetes self-management education and support in adults with type 2 diabetes: A\nconsensus report of the american diabetes association, the association of\ndiabetes care & education specialists, the academy of nutrition and\ndietetics, the american academy of family physicians, the american academy of\npas, the american association of nurse practitioners, and the american\npharmacists association","volume":"46","author":"M A Powers","year":"2020","journal-title":"Diabetes Educ"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1007\/s12020-015-0775-7","article-title":"The role of patient education in the prevention and management of type 2\ndiabetes: an overview","volume":"53","author":"A Coppola","year":"2016","journal-title":"Endocrine"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1007\/s12020-024-03839-8","article-title":"Therapeutic patient education and treatment intensification of diabetes and\nhypertension in subjects with newly diagnosed type 2 diabetes mellitus: A\nlongitudinal study","volume":"86","author":"A Coppola","year":"2024","journal-title":"Endocrine"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1016\/j.pcd.2026.01.006","article-title":"Incidence and predictors of diabetic foot ulcers in newly diagnosed type 2\ndiabetes without complications: A prospective longitudinal cohort study","volume":"20","author":"C Gazzaruso","year":"2026","journal-title":"Prim Care Diabetes"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"1720","DOI":"10.2337\/dc12-1401","article-title":"Transcutaneous oxygen tension as a potential predictor of cardiovascular events\nin type 2 diabetes: Comparison with ankle-brachial index","volume":"36","author":"C Gazzaruso","year":"2013","journal-title":"Diabetes Care"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1111\/j.1532-5415.2005.53221.x","article-title":"The montreal cognitive assessment, MoCA: A brief screening tool for mild\ncognitive impairment","volume":"53","author":"Z S Nasreddine","year":"2005","journal-title":"J Am Geriatr Soc"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"1912","DOI":"10.1016\/j.jamda.2021.02.033","article-title":"Diabetes and prediabetes inhibit reversion from mild cognitive impairment to\nnormal cognition","volume":"22","author":"K Makino","year":"2021","journal-title":"J Am Med Dir Assoc"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"2403","DOI":"10.18632\/aging.101924","article-title":"Identification of inflammatory and vascular markers associated with mild\ncognitive impairment","volume":"11","author":"X N Shen","year":"2019","journal-title":"Aging (Albany NY)"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/j.psyneuen.2008.01.002","article-title":"Plasma C-peptide levels and rates of cognitive decline in older,\ncommunity-dwelling women without diabetes","volume":"33","author":"O I Okereke","year":"2008","journal-title":"Psychoneuroendocrinology."},{"key":"ref22","doi-asserted-by":"crossref","first-page":"1624472","DOI":"10.3389\/fendo.2025.1624472","article-title":"A review of type 2 diabetes mellitus and\ncognitive impairment","volume":"16","author":"W Kan","year":"2025","journal-title":"Front Endocrinol\n(Lausanne)"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"106727","DOI":"10.1016\/j.ejim.2026.106727","article-title":"Expert consensus for the diagnosis and treatment of patients with hyperuricemia\nand high cardiovascular risk: 2025 update","volume":"146","author":"R Johnson","year":"2026","journal-title":"Eur J Intern Med"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1097\/BOR.0000000000000472","article-title":"Uric acid and cognitive decline: A double-edge sword?","volume":"30","author":"A Latourte","year":"2018","journal-title":"Curr Opin Rheumatol"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1007\/s40265-017-0839-5","article-title":"Effects of allopurinol on endothelial function: A systematic review and\nmeta-analysis of randomized placebo-controlled trials","volume":"78","author":"AF G Cicero","year":"2018","journal-title":"Drugs"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1055\/a-2813-5608","article-title":"Prevalence, incidence, and remission of erectile dysfunction in newly diagnosed\nand uncomplicated type 2 diabetic men: The role of testosterone, hyperuricemia,\nand patient education","volume":"58","author":"A Coppola","year":"2026","journal-title":"Horm Metab Res"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1007\/s12020-016-0947-0","article-title":"Structured therapeutic education in diabetes: Is it time to re-write the chapter\non the prevention of diabetic complications?","volume":"53","author":"C Gazzaruso","year":"2016","journal-title":"Endocrine."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1016\/j.pcd.2026.02.004","article-title":"Testing the use of retinal microvascular parameters to identify individuals with\ntype 2 diabetes with mild cognitive impairment","volume":"20","author":"F N Pedersen","year":"2026","journal-title":"Prim Care Diabetes"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1007\/s12020-022-03291-6","article-title":"Impact of microvascular complications on the outcomes of diabetic foot in type 2\ndiabetic patients with documented peripheral artery disease","volume":"80","author":"C Gazzaruso","year":"2023","journal-title":"Endocrine"}],"container-title":["Experimental and Clinical Endocrinology &amp; Diabetes"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2893-3900.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:35:41Z","timestamp":1792190141000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2893-3900"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,3]]},"references-count":29,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,10,16]]},"published-print":{"date-parts":[[2026,10]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2893-3900","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0947-7349","1439-3646"],"issn-type":[{"value":"0947-7349","type":"print"},{"value":"1439-3646","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,3]]}}}