December 14, 2012

Poor Glucose Control Impacts on Cognition

Now they want to add another complication to the list of diabetes complications. Cognition decline is now the result of poor blood glucose management. Cognition is the mental act or process by which knowledge is acquired, including perception, intuition, and reasoning. I can understand this happening, but how do they classify other people with cognition decline. Are they people with undiagnosed diabetes? I would be guessing, but I do believe some may have undiagnosed diabetes, but not a large number.

The study in Archives of Neurology says that, “poor glucose control in older, well-functioning adults with no dementia are linked to reduced cognitive function and higher cognitive decline.” The researchers conclude: "This study supports the hypothesis that older adults with DM have reduced cognitive function and that poor glycemic control may contribute to this association. Future studies should determine if early diagnosis and treatment of DM lessen the risk of developing cognitive impairment and if maintaining optimal glucose control helps mitigate the effect of DM on cognition."

Therefore, they are not saying type 2 only, but all with diabetes mellitus. The researchers from the University of California, San Francisco and the San Francisco VA Medical Center assessed 3069 patients and administered two tests. The two tests were the Modified Mini-Mental State Examination (3MS) and Digit Symbol Substitution Test (DSST). These tests were done at the beginning of the study and repeated at selected intervals over the 10-year period of the study. The average age of the patients was 74.2 years. Of the participants, 42% were black and 52% were female.

Of the participants, 717 had diabetes at the beginning of the study and 2352 has no diabetes. During the study, 159 participants developed diabetes. At the start of the study, those with diabetes had lower 3MS and DSST test scores than those without diabetes. At the 9-year mark, participants without diabetes had a similar pattern of decline. Those with diabetes and that developed diabetes, showed a marked decline in both the 3MS and DSST tests compared to those not having diabetes.

This points out how important good blood glucose management is for our brain health and the fact that poor management can bring on not only many complications, but cognitive decline as well.

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