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Cognition in Adults with Type 1 Diabetes

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Diabetes and the Brain

Part of the book series: Contemporary Diabetes ((CDI))

Abstract

In this chapter, the literature on the neuropsychology of type 1 diabetes is reviewed. First, the pattern and magnitude of cognitive impairments in adults with type 1 diabetes are discussed. Cognitive decrements are limited to only some cognitive domains and can best be characterised as a slowing of mental speed and a diminished mental flexibility, whereas learning and memory are generally spared. Also, the cognitive decrements are mild in magnitude (i.e. within 0.5 SD of the mean of the control group) and seem neither to be progressive over time, nor to be substantially worse in older adults. Next, we focus on the results of neuroimaging studies. These studies suggest that type 1 diabetic patients have relatively subtle reductions in brain volume but these structural changes may be more pronounced in patients with an early disease onset. Furthermore, we will highlight several possible risk factors and confounding variables, including psychiatric comorbidity, recurrent hypoglycaemia, and chronic hyperglycaemia, and we will address the apparent paradox between evidence of end-organ damage in the brain as a result of diabetes versus evidence of cognitive resilience. Finally, we will discuss the implications of these findings for understanding their effects on daily life.

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Author information

Authors and Affiliations

  1. Regional Psychiatric Centre/Zuwe Hofpoort Hospital, Woerden, The Netherlands

    Augustina M.A. Brands PhD

  2. Helmholtz Institute, Utrecht University, Utrecht, The Netherlands

    Augustina M.A. Brands PhD & Roy P.C. Kessels

  3. Donders Centre for Cognition, Radboud University, 6500, Nijmegen, HE, The Netherlands

    Roy P.C. Kessels

  4. Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen and Radboud University Nijmegen Medical Centre, Nijmesen, The Netherlands

    Roy P.C. Kessels

  5. Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Christopher M. Ryan PhD

Authors
  1. Augustina M.A. Brands PhD
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  2. Roy P.C. Kessels
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  3. Christopher M. Ryan PhD
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Corresponding author

Correspondence to Augustina M.A. Brands PhD .

Editor information

Editors and Affiliations

  1. Dept. Neurology, University Medical Center Utrecht, Utrecht, 3508 GA, Netherlands

    Geert Jan Biessels

  2. Medical Center, Columbia University, West 168th St. 622, New York, 10032, U.S.A.

    Jose A. Luchsinger

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Brands, A.M., Kessels, R.P., Ryan, C.M. (2009). Cognition in Adults with Type 1 Diabetes. In: Biessels, G., Luchsinger, J. (eds) Diabetes and the Brain. Contemporary Diabetes. Humana Press. https://doi.org/10.1007/978-1-60327-850-8_11

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  • DOI: https://doi.org/10.1007/978-1-60327-850-8_11

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