Managing Diabetes Symptoms Also Helps Memory

Cognitive Decline Addressed

New research shows that people with diabetes who reduce their blood sugar levels experience improvements in working memory, according to a report presented at a recent American Diabetes Association meeting.

While previous studies have shown that managing blood sugar can have beneficial effects on other complications of diabetes, such as kidney function, blindness and retinopathy, this latest study is the first to extend the effect to cognitive function, an area which has traditionally received less attention.

"The more they lowered their blood glucose levels, the better," said study co-author Dr. Christopher Ryan, a professor of psychiatry at the University of Pittsburgh School of Medicine. "Cognitive impairment may be reversible and preventable."

"Research has shown that people with type 2 diabetes are up to twice as likely as the general population to experience cognitive decline," says Dr. Richard Nesto, chairman of cardiovascular medicine at the Lahey Clinic in Massachusetts.

"There are 17 million people with type 2 diabetes in the US today, and even mild cognitive impairment can negatively impact learning and memory and may impact ability to perform routine tasks," Dr. Nesto says.

Diabetes is the sixth leading cause of death among Americans, and the fifth leading cause of death from disease. Although it is believed that diabetes is under-reported as a condition leading to or causing death, each year, more than 200,000 deaths are reported as being caused by diabetes or its complications.

Remembering New Information a Challenge

Common cognitive difficulties experienced by people with type 2 diabetes include difficulty learning new information and remembering that information, said study co-author Dr. Mark Strachan, of Western General Hospital in Edinburgh, Scotland.

Of particular concern to physicians is how these mental difficulties may impact management of the blood sugar disease.

"We have to keep in mind that the presence of even mild memory problems can affect quality of life in a variety of ways, including the ability to follow complex medical regimens, remembering whether or not you took your medication or tested your blood sugar," says Dr. Ryan.

"Mild memory problems can have a major impact on patients' adherence with medical management," he says.

This study, the largest ever to look at the effect of glycemic control on cognitive function in people with type 2 diabetes, set out to determine if there was a relationship between the two factors.

To that end, they recruited 141 people who, other than having been diagnosed with diabetes, were relatively healthy. The average age of the participants was 60.

All of the participants took the medication metformin, and were then split into two groups - one taking Avandia and the other taking glyburide.

Fasting plasma glucose was measured at the beginning of the 24-week trial, and all individuals took a battery of psychological tests to ascertain cognitive function. Three categories of function were assessed: learning ability, cognitive efficiency, and working memory.

"The main result of the study was improving glycemic control has no effect on learning ability or cognitive efficiency, but we found that in both arms of study there was a significant improvement in working memory across the 24 weeks," Dr. Strachan says.

"And in one of the major tests that made up the working memory domain, we saw that there was a 30 percent improvement in errors that patients made across the study," he says.

Working Memory Helps People with Diabetes

In both groups, working memory improvements correlated with improved control of blood sugar levels. "Those subjects that had the biggest improvement in glycemic control had the biggest improvement in working memory," Dr. Strachan says. The medication Avandia, however, had fewer side effects, he says.

"Our study reinforces the results of previous studies," Dr. Strachan says. "We know that good glycemic control and strict management of other diabetes-related parameters is good for your long-term health.

"This is one further reason why we should be striving to get good glycemic control," he says. "It's not doing any harm to get sugar under control better."

Always consult your physician for more information.

Online Resources

American Diabetes Association

Centers for Disease Control and Prevention (CDC)

HealthierUS.Gov

National Diabetes Education Program

National Diabetes Information Clearinghouse

National Institute of Diabetes & Digestive & Kidney Diseases

National Institutes of Health (NIH)

National Library of Medicine

Prevengamos la diabetes tipo 2. Paso a Paso

September 2004

Managing Diabetes Symptoms Also Helps Memory

Remembering New Information a Challenge

Working Memory Helps People with Diabetes

Diabetes Facts

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Diabetes Facts

Diabetes is a metabolic disorder characterized by a failure to secrete enough insulin, or, in some cases, the cells do not respond appropriately to the insulin that is produced.

Because insulin is needed by the body to convert glucose into energy, these failures result in abnormally high levels of glucose accumulating in the blood.

Diabetes may be a result of other conditions such as genetic syndromes, chemicals, drugs, malnutrition, infections, viruses, or other illnesses.

The three main types of diabetes - type 1, type 2, and gestational - are all defined as metabolic disorders that affect the way the body metabolizes, or uses, digested food to make glucose, the main source of fuel for the body.

In pre-diabetes, blood glucose levels are higher than normal but not high enough to be defined as diabetes. However, many people with pre-diabetes develop type 2 diabetes within 10 years, states the National Institute of Diabetes and Digestive and Kidney Diseases.

Pre-diabetes also increases the risk of heart disease and stroke. With modest weight loss and moderate physical activity, people with pre-diabetes can delay or prevent type 2 diabetes.

Diabetes and Blood Glucose

For glucose to be able to move into the cells of the body, the hormone insulin must be present. Insulin is produced primarily in the pancreas, and, normally, is readily available to move glucose into the cells.

However, in persons with diabetes, either the pancreas produces too little or no insulin, or the cells do not respond to the insulin that is produced.

This causes a build-up of glucose in the blood, which passes into the urine where it is eventually eliminated, leaving the body without its main source of fuel.

Three Types of Diabetes

Although the three main types of diabetes are similar in the build-up of blood glucose due to problems with insulin, there are differences in cause and treatment:

type 1 diabetes
Type 1 diabetes is an autoimmune disease in which the body's immune system destroys the cells in the pancreas that produce insulin, resulting in no or a low amount of insulin. People with type 1 diabetes must take insulin daily in order to live.

type 2 diabetes
Type 2 diabetes is a result of the body's inability to make enough, or to properly use, insulin. Type 2 diabetes may be controlled with diet, exercise, and weight loss, or may require oral medications and/or insulin injections.

gestational diabetes
Gestational diabetes occurs in pregnant women who have not had diagnosed diabetes in the past. It results in the inability to use the insulin that is present and usually disappears after delivery.

Gestational diabetes may be controlled with diet, exercise, and attention to weight gain. Women with gestational diabetes may be at higher risk for type 2 diabetes later in life.

Complications of Diabetes

Complications of diabetes include eye problems and blindness, heart disease, stroke, neurological problems, amputation, and impotence.

Because diabetes (with the exception of gestational diabetes) is a chronic, incurable disease that affects nearly every part of the body, contributes to other serious diseases, and can be life threatening, it must be managed under the care of a physician throughout a person's life.

Always consult your physician for more information.