Diabetes & Cognitive Impairment

Instructor: Artem Cheprasov

Artem has a doctor of veterinary medicine degree.

Did you know that in addition to damaging many other parts of the body, diabetes can damage the brain and lead to cognitive impairment? This lesson describes the many proposed mechanisms behind how this occurs.

Diabetes' Impact On The Body

Diabetes can damage the eyes, kidneys, heart, blood vessels, and even the nerves coursing through your limbs. It seems as if nothing is off limits to this horrendous condition. In fact, it appears that diabetes can even impact your most precious structure, the brain.

Let's find out how two unfortunate conditions, diabetes and cognitive impairment, are related.

What Are Diabetes & Cognitive Impairment?

Diabetes mellitus is an endocrine disorder that is most famously tied to two things: insulin and sugar. Insulin is a hormone that helps drive sugar from our blood into our body's cells, where it is used for energy. With diabetes, the body either doesn't produce enough insulin or the body can't use the insulin properly. This means the person experiences hyperglycemia, or high blood sugar.

In this image, you can see white hexagons, representing sugar molecules, floating in the blood. In hyperglycemia (bottom), there are more of these guys than there should be in normal blood (top).

Cognitive impairment is a term that refers to a state where a person has problems learning new things, like a new language. They may also have problems concentrating on a task, such as writing and mailing a letter. A person with cognitive impairment may have issues with memory, like remembering an appointment. Finally, individuals with cognitive impairment have difficulty making decisions, such as planning the steps needed to make tonight's dinner for guests. In severe cases, cognitive impairment may cause a person to lose their ability to talk, write, or understand the importance and meaning of everyday things.

How They Are Linked

While scientists know that diabetes can lead to cognitive impairment, they don't know exactly how this occurs. More than one factor is most likely at play. So, let's go over several possibilities. One possibility is the hyperglycemia mentioned above. It may be that hyperglycemia leads to increased levels of free radicals in the body. These substances react with and damage anything in sight, and may damage the brain in the process.

Similarly, low blood sugar (called hypoglycemia) is also bad. Diabetics who take too much insulin medication may cause hypoglycemia. This can be very dangerous. In fact, hypoglycemia has been linked to, at the very least, temporary and short-term cognitive impairment. That's because the brain is a massive powerhouse that thrives on sugar. If it doesn't get enough sugar, even in the short term, permanent brain damage may be the end result.

Another consequence of diabetes is damage to the body's blood vessels. Diabetes can cause arterial disease that increases the risk of stroke. Stroke is a condition that encompasses an impaired supply of oxygenated blood to a section of the brain. As with sugar, the brain demands massive amount of oxygen to do its job. During a stroke, a section of the brain is damaged beyond repair as a result of this lack of oxygen. As you can imagine, this may lead to decreased brain function and, consequently, cognitive impairment.

Finally, many cases of diabetes are associated with obesity (i.e. high levels of body fat). Body fat is living tissue that releases many inflammatory compounds. Inflammation is a biochemical process of the body that can damage and destroy tissues and organs, and the brain is no exception. It is hypothesized that inflammation stemming from obesity in some diabetics is a potential cause of cognitive impairment.

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