Type 1 diabetes

Impact of Blood Glucose Fluctuations on Cognitive Function in Type 1 Diabetes

New research suggests that significant fluctuations in blood glucose levels, common in individuals with type 1 diabetes, may impair the brain's ability to process information rapidly. This study, featured in npj Digital Medicine, indicates that these fluctuations might particularly affect certain individuals, including older adults and those with specific health conditions.

Co-senior author Naomi Chaytor, a professor at the Washington State University Elson S. Floyd College of Medicine, emphasizes that extreme blood glucose levels—both very low and very high—are linked to slower and less accurate cognitive processing speed. This cognitive processing speed is crucial for various everyday activities, such as driving, decision-making, and operating machinery.

The research team employed digital sensors to monitor glucose levels and smartphone-based cognitive tests in 200 participants from four major US diabetes centers. Over a 15-day period, participants underwent cognitive testing three times daily while their glucose levels were measured every five minutes.

The study revealed that cognitive processing speed suffered when glucose levels deviated significantly from the norm, with the most pronounced effects observed at low glucose levels. Interestingly, sustained attention—another cognitive aspect—was not significantly impacted by glucose fluctuations, although longer-term effects may exist.

Laura Germine, co-senior author and director of McLean Hospital's Laboratory for Brain and Cognitive Health Technology, suggests that sustained attention may be influenced by prolonged periods of high or low glucose levels rather than short-term fluctuations.

Furthermore, the study identified variations among participants in how glucose changes affected cognition. Factors such as age and certain health conditions (e.g., diabetes-related complications, fatigue, and sleep apnea risk) were found to predict who might be more susceptible to severe cognitive impacts.

An unexpected finding was that participants' peak cognitive performance aligned with slightly elevated glucose levels compared to their usual range. However, performance declined as glucose levels rose further. Chaytor suggests that individuals with diabetes may feel better at higher glucose levels due to brain adaptation.

Moving forward, the researchers aim to explore whether reducing time spent with glucose levels above the normal range, possibly through automated diabetes management systems, can shift peak cognitive performance into the normal range. Ultimately, they hope to devise strategies to optimize cognitive function in individuals with type 1 diabetes, potentially offering long-term health benefits amid concerns about cognitive decline and dementia risk in this population.
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