Managing diabetes can be a challenge at times. The many vital self-care tasks you do include checking your blood sugar, eating healthy, and exercising. You also need to keep track of your medicines and attend frequent appointments with your healthcare providers. Regular exams of your feet and vision checks are also needed. This can be a lot for anyone with diabetes. But all of these steps are so important and key to preventing complications of diabetes, including cognitive impairment.
Cognitive impairment (decline) affects your ability to think and reason. You may find you have trouble remembering, understanding, planning, or communicating. It can hamper your ability to problem-solve and make decisions. These problems can be frustrating and may lead to poor diabetes control. But by working closely with your healthcare team to simplify and support your care, you and your caregiver can successfully manage diabetes.
What causes cognitive impairment in diabetes?
Your brain needs oxygen-rich blood to be healthy and work correctly. But too much sugar in the blood (hyperglycemia) damages the blood vessels in the brain and throughout the body. This reduces blood flow to the brain. High blood sugar also causes inflammation. This may damage brain cells and cause dementia to develop. The brain depends on different chemicals, which may become imbalanced by too much insulin. Some of these changes may trigger cognitive decline.
The brain needs some glucose to work. So, low blood sugar (hypoglycemia) can also damage the brain.
To prevent or delay this damage, it’s best to keep your blood sugar as close to your target levels as possible. The longer your A1C blood levels are elevated, the greater your risk for cognitive impairment.
Symptoms of cognitive impairment in diabetes
You may have cognitive impairment if you have any of these symptoms:
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Are more forgetful
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Have trouble finding the right words
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Are easily distracted
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Have poor judgement
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Have trouble making decisions
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Have mood and personality changes
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Lose your train of thought
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Ask the same questions over and over
The symptoms can be caused by a number of things. Work with your healthcare provider to rule out other conditions.
Starting at age 65, your healthcare provider should screen you for early detection of mild cognitive impairment or dementia every year.
Treatment for mild cognitive impairment from diabetes
Treatment includes the following:
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Keep your blood sugar in your target range.
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Take medicines to help cognitive function, such as those used to treat Alzheimer’s.
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Make lifestyle changes such as getting regular physical activity and eating healthy snacks and meals.
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Manage other conditions, such as high blood pressure and cholesterol.
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Simplify your medicine plan, such as once-a-day medicine or automatic insulin delivery devices.
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Use continuous glucose monitoring (CGM).
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Get preventive vaccinations, such as those for pneumonia, flu, and COVID-19.
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Use reminders, calendars, and written instructions.
If you have mild impairment, it’s important to have an educated caregiver who can help support your care. If you don’t have a caregiver at home, think about hiring a paid caregiver or living in an assisted living facility.
Possible complications of cognitive impairment from diabetes
Complications include:
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Less independence
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Isolation
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Financial problems
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Poor blood sugar control and the health issues that may result from it
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Risk of accidents
When to call your healthcare provider
If you are having issues with memory, communicating, understanding, or planning, talk with your healthcare provider soon to create a treatment plan.
