The National Health Service carried out a study focusing on the frequency of cognitive impairment and the impact of cognitive impairment on the progression of diabetes. The study, published in the medical journal BMJ, found that diabetic patients who also exhibited cognitive impairment had higher blood sugar levels, suboptimal control of their diabetes, and less well-controlled associated conditions such as hyperlipidemia. found.
These patients also had higher rates of additional diabetes-related complications, such as foot ulcers and the need for foot amputation.
Within the scope of the study, a cognitive assessment (using the MoCA test) was carried out on 350 patients. The aim was to identify differences between diabetic patients with normal cognitive status and diabetic patients diagnosed with cognitive impairment. They found that 37% of participants had normal cognitive status, 43% exhibited cognitive decline, and 20% were diagnosed with severe cognitive decline. The patients were previously unaware of their cognitive impairment and had not been diagnosed prior to this study.
The study also found that patients with poorly controlled diabetes were less likely to see their primary care physician or dietitian, and were more likely to be hospitalized or visited the emergency department. Additionally, an association was observed between the quality of care received and patients’ cognitive status. People with cognitive impairment were less likely to be prescribed advanced diabetes medications, even though these new drugs are more effective, protect the heart and kidneys, and in some cases help with weight loss.
The researchers speculated that these patients were seeing fewer GP visits because they had difficulty self-care. Additionally, new treatments are complex and it is difficult to explain and implement medication changes in these patients, so physicians tend to continue with existing treatments rather than switching to more advanced treatments. had.
Diabetes cases are increasing not only in Israel but all over the world. According to Ministry of Health statistics, more than 10% of the population suffers from diabetes. People with diabetes have many potential complications, including an increased chance of heart and blood vessel disease and stroke. Among these, decline in memory and cognitive ability is a less recognized but important complication. The probability of dementia in a diabetic patient can be as much as 60% higher than in a non-diabetic person. The main causes are thought to be a decrease in cerebral blood flow due to vascular damage and the negative effects on the brain due to high blood sugar levels.
Managing diabetes can be complex, requiring multiple medications given at different intervals throughout the day, the use of injectable medications, adherence to a low-carbohydrate diet, and regular check-ups. Therefore, cognitive decline may compromise disease management.
This study highlights the need to increase awareness of cognitive decline as a risk factor for complications and suboptimal treatment in patients with diabetes. The main takeaway from this study is that it is important to investigate and diagnose cognitive decline in patients with diabetes when it is suspected. It is important to find solutions that allow for optimal treatment, such as enlisting the help of family members or care arrangements where caregivers can support patients at home. Additionally, it is important to devise treatment plans that are easy to understand and implement for these patients.
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