The incidence of Type 2 diabetes has been dramatically increasing over the last decade. Once a person is diagnosed with Type 2 or adult onset diabetes, blood sugar must be monitored and kept under control. A new study published in the journal Diabetes Care linked poor blood sugar control in elderly Type 2 diabetics to advanced cognitive decline.
Good blood sugar control is defined as fasting blood sugars below 100 and two hour post-prandial blood sugars below 140. Another method of assessing blood sugar control is Hemoglobin A1c (Hb A1c). Hb A1c should be below 7% in a healthy person with normal blood sugars, in diabetics this number can double or triple. The level of elevation in Hb A1c can determine a diabetics risk for complications.
Complications of diabetes include damage to the kidneys, eyes, and peripheral neuropathy. People with Type 2 diabetes are also at risk for other chronic conditions including heart disease and cancer.
This new study from the Joslin Diabetes Center in Boston examined the rate of cognitive decline in relation to blood sugar control in elderly subjects with Type 2 diabetes. Sixty diabetics were enrolled and Hb A1c was assessed to determine blood sugar control. Each person was then given a series of cognitive tests including the Mini Mental Examination and a drawing test. Activities of daily living, fall history, and presence of other disease were also taken into consideration.
As a group, the average Hb A1c was 7.9%, which is above normal and indicates most had poor blood sugar control. More than a third of the subjects had poor cognitive function as assessed by the Mini Mental Examination and the drawing tests. Subjects with pschological disorders such as depression were more likely to have difficulty completing tasks of daily living but this did not effect blood sugar control. Other impairments in the group were linked to poor control and included hearing and vision impairment.
Overall the authors believe the study supports the belief that elderly individuals with poor blood sugar control suffer greater cognitive decline than those with adequate blood sugar control. They caution that these patients may need a more individualized treatment plan to help maintain adequate blood sugar control and limit impairment in other areas. Because there is often more than one condition that needs to be addressed a comprehensive team of healthcare providers may best serve this population.
Posted by Dr. Christina Gutierrez on September 12, 2006 03:49 PM
