Dementia and Diabetes

A chronic illness alone may seem like too much to cope with, but unfortunately, one chronic condition can often compound the effects of another. Diabetes is one such disease that increases a patient's risk of developing a whole slew of other conditions, especially cardiovascular disease. 

On its own, diabetes is the seventh leading cause of death in the U.S., according to the Centers for Disease Control and Prevention (CDC). It seems that among older adults with diabetes, there is also an association between low blood sugar (hypoglycemia) and dementia, say researchers at the University of California, San Francisco (UCSF) in a new study published in the Journal of the American Medical Association. This can create a dangerous spiral, in which a hypoglycemic event caused by diabetes can lead to mental deterioration and vice versa.

“The brain uses glucose as a primary source of energy. Cognitive function becomes impaired when blood glucose drops to low levels, and severe hypoglycemia may cause neuronal damage,” the study authors wrote.

Diabetes is a set of chronic conditions that affect the production and regulation of the hormone insulin. Insulin helps blood cells take up glucose, which means that for diabetics, getting glucose to the brain is a difficult task. If the brain is starved of energy, it’s possible that neurological problems like dementia and Alzheimer’s disease are more likely to develop.

The UCSF researchers found that the relationship between dementia, Alzheimer’s, diabetes, and hypoglycemia is mutual. “We found that clinically significant hypoglycemia was associated with a two-fold increased risk for developing dementia…similarly, participants with dementia were more likely to experience a severe hypoglycemic event,” the study authors wrote.

Breaking the Vicious Cycle

More than 3,000 participants were enrolled in this study, and at the time the study began, just over a quarter had diabetes but were without cognitive impairment. In the following 12 years, 61 participants with diabetes reported a hypoglycemic event that landed them in the hospital, while 148 participants developed dementia.

The older adults who had a hypoglycemic event resulting in hospitalization were more likely to develop dementia, and the risk was greater after multiple episodes, the researchers found.

The nature of the relationship between these two conditions is a little murky, though the researchers say hypoglycemia may contribute to the development of dementia by causing brain damage in the cerebral cortex and hippocampus. The insulin deficiency caused by diabetes may also contribute to cognitive decline, according to researchers from the Royal Infirmary of Edinburgh in the UK. 

“Hypoglycemia may impair cognitive health, and reduced cognitive function may increase the risk for a hypoglycemic event that could further compromise cognition, resulting in a detrimental cycle,” the study authors concluded.

To break the cycle, the authors recommend including cognitive function tests and therapy in the management and care of older patients with diabetes.

Learn More: