Research results suggest that lowering chronically high glucose values (A1C) could slow the decline in cognitive function

Chronically high blood glucose values found in people with diabetes is linked to lower cognitive functioning, according to a study published last week in the journal Diabetes Care.

The large American-Canadian study on Memory in Diabetes (MIND), a sub-study of the Action to Control Cardiovascular Risk in Diabetes (ACCORD), found that higher levels of A1C (a measure of the average blood glucose levels over a 2-3 month period) are significantly associated with poorer performance on three cognitive tests that require memory, speed and the ability to handle several tasks simultaneously. Furthermore, higher A1C levels were also linked to a lower score on a test of global cognitive function.

Previous studies showed that people with diabetes are 1.5 times more likely to experience cognitive decline and 1.6 times more likely to develop dementia than people without diabetes. The MIND results suggest that diabetes might be associated with mild cognitive impairment.

"Even a mild impairment in cognitive function is worrisome for people with diabetes," said principal investigator Dr. Tali Cukierman-Yaffe, of the Gertner Institute for Epidemiology, the Endocrinology Institute at Sheba Medical Center and Sackler School of Medicine at Tel-Aviv University in Israel. It should be noted that these results are cross-sectional and it therefore cannot yet be determined whether chronically high levels of blood sugar increase the future risk of cognitive impairment or whether impairment of this type decreases the individual's ability to balance blood sugar levels.

The final results of the ACCORD-MIND study will provide some of these answers because the cognitive tests will be administered three times during the trial. One aim of ACCORD-MIND is to test the hypothesis that lowering A1C could result in improved cognitive function.

The ACCORD-MIND study is funded by National Institute on Aging.

The ACCORD trial is funded by the National Lung and Blood Institute.

Additional support came from NIDDK, the National Eye Institute, and the Centers for Disease Control and Prevention (CDC).

A diabetes clinic for older adults is currently being established at Sheba Medical Center. Among other issues, it will deal with the cognitive impairment that has been linked to diabetes.

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