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Cognitive Decline and Dementia Risk in Type 2 Diabetes

Members of the College of Family Physicians of Canada may claim one non-certified credit per hour for this non-certified educational program.

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Liesel-Ann Meusel1, PhD, Ekaterina Tchistiakova2,3, BSc, William Yuen4,5, BSc, Bradley J Macintosh2,3, PhD, Nicole D Anderson1,6, PhD, and Carol E Greenwood4,5, PhD
1Rotman Research Institute, Baycrest Centre, Toronto, ON. 2HSF Centre for Stroke Recovery, Sunnybrook Research Institute, Toronto, ON. 3Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, ON.
4Kunin-Lunenfeld Applied and Evaluative Research Unit, Baycrest Centre, Toronto, ON. 5Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON. 6Departments of Psychology and Psychiatry, University of Toronto, Toronto, ON.

Abstract
Type 2 diabetes mellitus is increasingly common, and previously unrecognized complications are emerging; namely, cognitive impairment and dementia. The mechanisms that link these factors together are still unknown, but likely result from the interplay of several variables, including vascular change, poor glycemic control, inflammation, and hypothalamic pituitary adrenal overactivity. At present, it is still too early to propose best practices related to the management of diabetes-induced cognitive change. All things considered, however, patients should be aware that proper management of metabolic and vascular complications may minimize the adverse effects of type 2 diabetes on cognitive function and quality of life.
Keywords: type 2 diabetes, cognition, dementia, vascular, metabolic
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Comments

with this study it is important for clinicians to educate their diabetic patients the importance for them to control their diabetes so as to reduce their risk of cognitive decline.

This article shows the importance of educating patients with DM also about this very worrisome risk, giving another very serious reason to stress optimum control of their sugar.

At least it appears that a more clearly supported link can be demonstrated between cognitive decline and better control but what, if any, connection is there between cognitive decline and hypoglycaemia just before we go too far the other way?

It is worrisome that diabetic people are at increased cognitive decline risk among all of their other risks.

I wonder if these diabetic patients with dementia have atherosclerosis as their main risk factor for dementia.

Excellent review of pathogenesis and possible links to dementia in pts with DM.It is positive to see that good control of DM can reverse soem aspects of cognitive decline.

It is worrisome that these patients are at risk for so many problems.