Cognitive decline associated with type 2 diabetes could be managed with early intervention

New research from the American Diabetes Association advises controlling symptoms of type 2 diabetes, including hyperglycemia and blood pressure control, may help prevent the decline of cognitive performance associated with the disease.

A group of researchers drew cross-sectional data from the Maastricht Study—a Netherlands-based phenotyping study focused on the etiology of type 2 diabetes—in an effort to evaluate the effects of hyperglycemia, insulin resistance and blood pressure on the cognitive performance of patients with differing glucose metabolisms.

Of the 2,531 men and women recruited for the ADA study, 666 had been previously diagnosed with type 2 diabetes, and 1,412 had hypertension, the study stated. A handful of participants—399—reported having previous heart disease. The pool was 52 percent men, had an average age of 60 and a mean body mass index of 26.9. According to the study, each participant completed a neuropsychological test battery in which hyperglycemia, insulin resistance and blood pressure were all measured through a range of different variables.

In addition to body measurements and blood tests, patients submitted to a series of cognitive challenges, which included verbal learning tests, the Stroop Color Word Test, the Concept Shifting Test and the Letter-Digit Substitution Test.

Once researchers adjusted results for age, sex and education, they found patients with type 2 diabetes performed worse in all cognitive areas—memory, speed processing and executive function and attention—when compared with individuals with normal glucose metabolism. Scientists attributed the diminished ability to process speed, as well as executive function and attention deficits, to hyperglycemia. Processing speed was linked more closely to blood pressure, and memory couldn’t be explained by any of the studied variables.

Smaller-scale studies have completed similar tests in the past, correlating acute hyperglycemia with poorer memory, information processing and attention span. One study found that patients with type 2 diabetes tended to experience poorer moods, too, with reduced energy and increased anxiety.

The new research suggests there might be hope in controlling diabetic risk factors before the onset of type 2 diabetes, which could improve the quality of life for patients struggling with the disease.

“Our cross-sectional data suggest that early glycemic and blood pressure control, perhaps even in the prediabetic stage, may be promising therapeutic targets for the prevention of diabetes-associated decrements in cognitive performance,” the authors wrote.