Cognitive impairment is increasingly recognized as a chronic complication in type 1 diabetes mellitus (T1DM), but early identification remains challenging. A cross-sectional study published in Journal of Diabetes and Its Complications evaluated clinical risk factors and serum amino acid profiles associated with mild cognitive impairment (MCI) in adults with T1DM.

The study included 119 participants, comprising 39 individuals with T1DM and MCI, 48 with T1DM and normal cognition, and 32 healthy controls. MCI was defined using a Montreal Cognitive Assessment (MoCA) score below 26. Serum amino acid levels were measured using ultra-performance liquid chromatography–tandem mass spectrometry, and analyses included logistic regression and receiver operating characteristic (ROC) curves.

The mean participant age was 36 years, and 44% were female. Among patients with T1DM, median disease duration was 7 years (range 3-15). Older age was associated with higher odds of MCI (odds ratio [OR] 1.060; P=0.008), while higher educational level was associated with lower odds (OR 0.851; P=0.038).

Compared with individuals with normal cognition, those with T1DM-MCI showed significantly lower levels of seven amino acid metabolites. Among these, L-valine demonstrated moderate ability to distinguish MCI status, with an area under the curve (AUC) of 0.745 (P<0.001), sensitivity of 72.7%, and specificity of 75.7%.

These findings indicate that alterations in amino acid metabolism are observed in adults with T1DM and MCI, with L-valine showing potential as a marker to differentiate cognitive status in this population.