Dynamics of Diabetes: Diabetes and Cognitive Decline



Dynamics of Diabetes: Diabetes and Cognitive Decline
            The issue of the aging population and type 2 diabetes are major public health concerns in the 21st century. By the year 2050 it is estimated that the number of individuals aged 65 and older will exceed 83 million. In addition, the prevalence of type 2 diabetes is expected to dramatically increase, affecting one of three elderly individuals over the age of 65 years old. Furthermore, as the aging process continues cognitive decline is common, ranging from mild cognitive impairment which includes difficulties with memory, verbal communication, and thinking and judgement abilities to dementia, which can be detrimental enough to impede an individual’s ability to function and be self-sustaining on a daily basis.
            Previous research has provided a link between cognitive decline and blood glucose control, but clinical trials have not been able to support this theory due to short lengths of time the study was implemented in the elderly participants. However, a study that was published in the Annuals of Internal Medicine journal in 2014 found that participants with diabetes with poor blood glucose control in middle age had an average of a 19% increase in the decline of their cognitive abilities later in life as compared to individuals in the study without diabetes. In addition, this study also found that individuals who were diagnosed with diabetes appeared to have increased aging effects of their minds, aging five years faster than expected with the normal advanced aging effects.
            Due to the complex and intensive treatment and care of type 2 diabetes, patients with type 2 diabetes require a higher level of cognitive function to appropriately provide self-care and diabetes self-management for themselves. Therefore, it is crucial that dietitians provide middle aged adults with education about diabetes and how blood glucose control can protect against cognitive diseases later in life. According to Ruth Frechman, MA, RDN, CPT dietitians should occasionally check blood levels of folate, vitamin B6, and B12, especially if a patient is taking Metformin, a common drug prescribed to diabetes patients, which can cause vitamin B12 and folate deficiencies. In addition, this dietitian suggests that patients should be encouraged to increase their fatty fish, and use of anti-inflammatories such as turmeric in their cooking process, control their blood glucose, blood cholesterol, blood pressure, and weight within the healthy normal limits, and stop smoking.
            With the great and unique position that dietitians play in the clinical management and treatment of diabetes they are in the perfect position to help patients preserve their cognitive abilities. By practicing quality care and effective counseling skills dietitians can make a substantial difference in this field of clinical dietetics. 

References:
Brown-Riggs, C. (2015). Dynamics of diabetes: Diabetes and cognitive decline. Today’s Dietitian, 17(8), 18. Retrieved from http://www.todaysdietitian.com/

-KP 

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