Blood sugar levels that are too high or too low can slow cognition in people with type 1 diabetes

Research has shown that fluctuations in blood sugar levels can affect cognitive health.Digital Vision/Getty Images
  • Type 1 diabetes is an autoimmune disease that affects the pancreas and insulin production.
  • Previous research has shown that people with type 1 diabetes are at increased risk for several health conditions, including eye problems and heart disease.
  • Researchers at McLean Hospital believe that the natural fluctuations in blood sugar levels that occur in people with type 1 diabetes may also affect cognitive function, which could influence the risk of Alzheimer’s disease.

As of 2021, approx. 8.4 million people There are people all over the world with type 1 diabetes. Researchers predict that this number will increase by about 500,000 new people each year, reaching 17.4 million people with type 1 diabetes worldwide by 2040.

Unlike type 2 diabetes, type 1 diabetes autoimmune disease There is currently no cure. This type of diabetes negatively affects the pancreas, making it unable to produce enough insulin, a hormone that helps the body manage blood sugar levels.

Previous research has shown that people with type 1 diabetes are at increased risk for several health conditions, including: cardiovascular disease, nerve damage, eye problemsand cognitive problems.

Now, researchers at McLean Hospital, part of the Massachusetts General Brigham, believe that the natural fluctuations in blood sugar levels in people with type 1 diabetes may affect how the brain works.

This study was recently published in the journal npj digital medicine.

according to Dr. Zoe HawkesDirector of the Computational Modeling and Cognitive Dynamics Program at McLean Hospital, Lecturer in Psychiatry at Harvard Medical School, and the study’s lead author, physicians and researchers are investigating how type 1 diabetes affects the brain. We need a deeper understanding.

“People with type 1 diabetes are at increased risk of cognitive impairment, and cognitive fluctuations are important indicators of long-term brain health,” Hawkes explained. Today’s medical news. “Understanding how glucose influences cognitive fluctuations in the context of clinical risk factors such as microvascular complications could provide new tools to assess and monitor brain health in type 1 diabetes. It may support development.”

Past research has linked type 1 diabetes to cognitive problems. For example, a study published in March 2022 found that older adults with type 1 diabetes cognitive decline compared with type 2 diabetic or nondiabetic patients.

A study published in November 2018 found that older adults with type 1 diabetes had the following symptoms: suboptimal or insufficient Poor blood sugar control in diabetes increased the risk of dementia.

A study published in July 2021 reported severe symptoms. Hypoglycemic and hyperglycemic events Increased risk of dementia in older adults with type 1 diabetes.

For the study, Dr. Hawkes and her team recruited 200 people with type 1 diabetes and collected blood sugar levels and cognitive data three times a day for 15 days using a digital blood glucose sensor and a smartphone-based cognitive test. Did.

“Type 1 diabetes is characterized by elevated blood sugar levels and increased fluctuations in blood sugar levels,” Dr. Hawkes said.

“Previous laboratory studies have shown that extreme blood sugar levels impair cognitive function. However, technical limitations have made it difficult to study the effects of glucose on cognition outside the laboratory. has historically been difficult. We will use new remote data collection techniques to understand how glucose affects cognition in daily life and whether this effect differs from person to person. “I was interested in that,” she explained.

Scientists analyzed data collected and found that when a person’s blood sugar levels are significantly higher or lower than normal, cognitive functions such as processing speed (how quickly the brain receives, processes, and reacts) are impaired. It has been found. However, this was not the case for another cognitive function called sustained attention, the ability to focus on a particular task for a long time.

“This finding was unexpected, but not entirely surprising,” Dr. Hawkes said.

“This may reflect the fact that fluctuations in blood sugar affect sustained attention and processing speed on different time scales. For example: Recent research by Pyatak and colleagues We suggest that sustained attention varies depending on the long-term effects of glucose (e.g., over hours, days), whereas processing speed was found to be more sensitive to current glycemic status. ” she said.

The researchers also found that the study participants’ peak cognitive performance coincided with blood sugar levels slightly above the normal range. However, as blood sugar levels continued to rise, performance decreased.

“This was surprising. We know that high blood sugar levels have negative effects on long-term brain function and cognitive health, but at least in the short term, moderately high blood sugar levels may be a contributing factor to the thinking of people with type 1 diabetes. It seems to be related to time and fast reaction rates.”
— Dr. Zoe Hawkes

“This is important for patients to know, because if someone is working hard to lower their blood sugar levels to a healthier range, they may find that their thinking is a little slower than normal. These are expected to be short-term effects as the body adapts to lower blood sugar levels. People with higher average blood sugar levels have lower average thinking speeds than people with lower average blood sugar levels. ,” Dr. Hawkes explained.

Dr. Hawkes said there are two major takeaways from this study that medical professionals should be aware of.

“First, the same glucose level may be associated with thinking difficulties for one person and not another, meaning that no two patients are exactly the same in terms of how glucose affects cognition. It supports a personalized approach that recognizes the

“Second, contrary to what many of us believed, mild to moderate hyperglycemia does not seem to be associated with thinking difficulties,” Hawkes continued. “For example, if someone with type 1 diabetes is about to take a high-stakes test and their blood sugar level is a little high, that range is associated with good overall cognitive function, so the test will There’s no need to worry.”

After reviewing this research, Dr. Swapnil Patelvice president of medicine at Hackensack Meridian Jersey Shore University Medical Center in New Jersey, told MNT that it would be interesting to see how blood sugar control affects the brain in different ways.

“This study proves that there is much to learn about how type I diabetes and blood sugar control affect the brain in the short and long term,” Dr. Patel continued. “Also, continuous blood glucose monitor My knowledge of diabetes and my ability to improve my blood sugar control has improved. ”

“This article demonstrates the importance of glycemic control in everyday brain health. Additional research is important to further validate this information. Also, to learn more about glycemic control and its effects, It is also important to see how we can further leverage the use of continuous glucose monitoring technology.”
— Dr. Swapnil Patel

MNT I also talked to Dr. Jennifer Chenchief of endocrinology at Hackensack Meridian Jersey Shore University Medical Center in New Jersey, said of the study:

Dr. Chen said this study reflects what is seen in clinical practice.

“This study states that perhaps patients are getting used to and adapting to certain blood sugar levels,” she continued. “It would be interesting to see further research on what kind of blood sugar levels patients become accustomed to and how cognitive performance changes over time after consuming carbohydrates with better glycemic control.”

“It would be interesting to know whether the best cognitive performance is due to patients’ emotions or to their actual performance. Another area of ​​research that would be interesting to see results is in diabetic patients with recurrent hypoglycemia. “How much brain damage is occurring?” Dr. Chen added.

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