A study by a team of researchers from the Medical School of the Pontifical Catholic University of Parana, published in the scientific journal Diabetology & Metabolic SyndroME, showed worsening cognitive deficits (learning difficulties) in patients with type 2 diabetes.

Patients with diabetes are more at risk of learning difficulties – Photo: Marcello Casal Jr/Agência Brasil/ND

According to the WHO (World Health Organization), more than 16 million adults in Brazil have type 2 diabetes (a disease characterized by high blood glucose levels).

SBD (Sociedade Brasileira de Diabetes) reported that about 90% of patients have type 2 (DM2) when the body cannot properly use the insulin it produces or does not produce enough of the hormone to control blood glucose levels. The disease leads to potential complications, including cognitive decline.

Evaluation of this issue prompted PUCPR researchers to study 250 adult type 2 diabetic patients at a university hospital. The survey was conducted between 2018 and 2021 and was postponed due to the COVID-19 pandemic. PUCPR Professor Ana Cristina Ravazzani de Almeida Faria, PhD student in the Postgraduate Program in Health Sciences, told Agência Brasil today (14th) that it is already known that patients with diabetes experience a deficit of more cognition over time or a higher likelihood of have cognitive deficits than people without diabetes.

conclusions

“We looked to see if we could determine among these diabetics who were more likely to have this cognitive deficit, or who were more likely to develop into more cognitive decline over time than the rest of the group,” said Ana Cristina. .

Physicians and medical students participating in the study concluded that the most susceptible patients were people with low levels of education, over 65 years of age, with more than 10 years of diabetes and already with cardiovascular disease, with or without diabetes. him, and suffering from diabetic retinopathy. In addition, patients with depressive symptoms are also more susceptible.

“We were able to identify the sector with the highest risk within the group,” he said. Of the 250 patients studied, 14% had cognitive deterioration over the 18 months of the study. An initial evaluation of the patients was carried out and, on average, a new evaluation was carried out after one and a half years. “This subgroup of 14% showed the worst results,” said Ana Cristina.

During routine consultations and follow-up, patients underwent a physical examination, screening for symptoms of depression, and cognitive tests, including a mini mental status test, a semantic verbal fluency test, a trace A and B test, and a memory test. Demographic data such as age and education associated with lifestyle and duration of diabetes were also analyzed.

Cognitive Assessment

International guidelines recommend that patients over 65 years of age undergo a cognitive assessment because it is known that there is a higher risk and that cognitive decline can affect quality of life and self-care.

However, Ana Cristina said that in public hospitals it is more difficult to do this type of evaluation for all patients, also because they are only referred for a cognitive evaluation when they have complaints such as memory loss.

“But all the patients we examined did not complain and said that everything was fine with them. Or that they had a very vague complaint. They had no previous assessment or diagnosis of cognitive dementia. Whoever it was, they didn’t even enter the studies, ”he assured.

Researchers suggest that people with type 2 diabetes have at least one cognitive assessment per year after age 60 or 65, which is the most vulnerable age group. The research team continues to follow the patients in the first study and is expanding to others. “We want to make this part of our service routine. This is our original plan,” he said.

Patients originally evaluated will be re-examined to see if anyone has worsened or if there has been any improvement. This new study will be overseen by the neurology sector.

The goal is to get more patients, in addition to continuing to follow up those who participated in the first study at least once a year. The team also wants to collaborate with professionals in the field of psychology, who have a field called neuropsychology that applies cognitive tests.

“We’re looking to form a partnership so they can participate.” A new stage of research, already with the inclusion of the field of psychology, should start in 2023.

Risk factors

Some risk factors are associated with habits, such as smoking and physical inactivity, which can be controlled to minimize the impact of the disease on cognitive function. Because lower levels of education also reflect cognitive deficits in patients with type 2 diabetes, the researchers noted that it is critical for the government to invest more and more in education.

In addition to Ana Cristina Ravazzani de Almeida Faria, the work was signed by PUCPR School of Medicine researchers Jocelyn Franco Dall’Agnol, Aline Maciel Gouveia, Clara Inacio de Paiva, Victoria Chechetto Segalla and Cristina Pellegrino Baena.