Takes a toll on the brain, diabetes

Having Type 2 diabetes is associated with greater impairment of blood flow to the brain and a sharper decline in mental acuity compared with nondiabetic people of similar age and health status, even over a two-year period, researchers report.

The study, published in Neurology, included 40 people whose average age was 66, half of whom had been in long-term treatment for Type 2 diabetes. All were tested at the start of the study and then two years later with M.R.I. scans, various blood tests and several tests of cognitive ability.

At the end of two years, people with diabetes had greater declines in gray matter volume, composite scores on mental tests, and in rates of blood flow to the brain than those in the control group. They also had greater increases in blood measures of inflammation. Among the group with diabetes, those with more severe declines in cerebral blood flow had correspondingly greater declines on tests of mental skills.

“There is currently no treatment for cognitive decline in diabetes,” said the lead author, Dr. Vera Novak, an associate professor of neurology at Harvard. “Even tighter glycemic control did not improve things. We are doing a new trial to assess whether injecting insulin into the brain through the nose could improve cognitive function or slow down cognitive decline.”

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