Can Diabetes Lead To Cognitive Impairment?
Diabetes is a group of diseases that result in too much sugar in the blood (high blood glucose). Many often think it only affects the blood sugar levels, however recent studies are showing that diabetes can also lead to cognitive impairments. Jose A. Luchsinger, MD of Columbia University Irving Medical Center has been studying and teaching about the influence of diabetes on cognitive impairment. In this blog article, we are going to share Dr. Luchsinger’s insight on the relationship between diabetes and cognitive impairment and how health care professionals can adapt treatments to assist their patients.
Research has found that those with diabetes are more likely to develop cognitive problems, especially older adults. They have higher chances of developing dementia, Alzheimers, and vascular dementia. Like with growing age, cognitive problems begin to appear, but the process becomes much faster in those with diabetes. Diabetes can cause cerebrovascular disease—that is, vascular disease in the brain—just as it can cause vascular disease in the heart or in the legs. This damage in the brain can lead to different cognitive problems, depending upon where damage occurs in the brain. Research is beginning to show a correlation between having diabetes and having memory issues. However, it is unclear whether the decline in memory is caused by vascular problems or by other mechanisms. Researchers are interested in figuring this out.
What Exactly Happens?
Executive functioning, psychomotor speed, and attention are some of the cognitive functions that first become impaired. A patient may then begin to develop memory problems, causing them to start to forget appointments or forget to take their medication. If these cognitive symptoms persist, health care providers should recognize there is a possible condition that is underlying these behaviors. To help slow this process, patients with diabetes must follow a treatment process that helps them use and improve these cognitive functions.
How Can Someone Help?
Luchsinger recommends, first and foremost, being patient and helpful. Make sure to help your clients keep up with their medication and inform you when a problem arises. For caregivers, it is important that you work with your loved one on making healthy food choices and helping them exercise. Engaging in a healthy lifestyle is essential for tackling diabetes head-on.
Can improved glucose control or diabetes treatments help prevent cognitive impairment?
Some studying the effect of diabetes on cognitive impairment believe that improved glucose control can prevent these cognitive impairments. Several studies suggest that metformin, an anti-diabetic drug, may be used to treat and or prevent Alzheimers. However these results have only come from mild cases. Several studies have also disputed the idea that improved glucose can control cognitive impairments. A sub-study called MIND, found no cognitive benefits to using glucose control as a treatment. Another study known as the Diabetes Control and Complications trial, found that there was no relationship between glucose levels and cognitive disorders.
Healthcare professionals need to treat patients that have both diabetes and cognitive impairment very carefully. Those with both conditions may have a hard time following a treatment plan or taking medications. Patients who live alone are at even greater risk of not completing their treatment plans, as they do not have additional help readily available. One recommendation is to have a visiting nurse or support provider come check on patients daily. Another recommendation is using smartphones or smartwatches for reminders. Therapists may want to work with clients on cognitive skills using digital cognitive therapy tools, good cognitive worksheets, and by providing group therapy for their clients. Helping clients live a healthy lifestyle may also help them ward off further problems caused by diabetes and become healthier overall.
José A. Luchsinger, MD, National Institute of Diabetes and Digestive and Kidney Diseases, (2021) Can Diabetes Lead to Cognitive Impairment?