Aggressive management of diabetes can lead to more episodes of severe low blood sugar, but a new study has found that these episodes apparently don’t impair cognitive (thinking) function.

Research recently published in the New England Journal of Medicine examined the cognitive abilities of 1,144 people who had participated in the Diabetes Control and Complications trial (DCCT) eighteen years ago. The researchers first looked at the subjects’ cognitive abilities at the start of the study; then they re-administered the same battery of tests the subjects had taken in the first place. Over the eighteen-year period, people who intensively managed their blood glucose levels (defined by an A1c of less than 7.4 percent) experienced relatively high rates of recurrent severe hypoglycemia, but their cognitive function was not damaged.  In fact, the study found a small decrease in motor speed and psychomotor efficiency in people who had not managed their diabetes as well (defined by an A1c of above 8.8 percent). The researchers concluded that poor glycemic control may be associated with mild cognitive impairments  due to cerebral microangiopathy (weakening and thickening of the capillaries).

The researchers noted that the study underlined the safety of intensive diabetes therapy for people diagnosed as young adults, but that it did not really address the questions of people diagnosed very young, the elderly, or those living more than thirty years with diabetes. On the whole, though, the message is an optimistic one.

Source:  New England Journal of Medicine