Scary but true: When you have diabetes, it can affect your brain. In fact, your chance of developing dementia and cognitive decline is at least 1.5 times higher compared with someone who doesn’t have diabetes. And the risk for a decline in brain function is higher both in people who have Type 1 and Type 2 diabetes.
Some research even finds a greater risk for all-cause dementia when you have diabetes — up to 2 to 2.5 times higher, says Luke Stoeckel, program director at the Division of Diabetes, Endocrinology and Metabolic Diseases for the National Institute of Diabetes and Digestive and Kidney Diseases.
The higher chance of developing cognitive impairment and dementia is often linked to microvascular damage — in other words, damage to small blood vessels — directly related to diabetes, says Dr. Jeffrey Klingman, chief of neurology at Kaiser Permanente in Walnut Creek, California.
[Read: 8 Complications of Diabetes.]
“Studies show that in addition to loss of nerve cells, there is also a change in the way brain cells work when someone has diabetes,” says Dr. Melissa Young, an endocrinologist on staff at CentraState Medical Center in Freehold, New Jersey. “And the higher blood sugars are, on average, the higher the risk.” Repeated low blood sugar, or hypoglycemia, is also associated with cognitive decline, Young adds.
Of course, the risk of cognitive decline increases with age, as does the risk for diabetes. That’s another reason why these problems may go hand in hand. Obesity and sleep are also associated with brain issues, but there are very few studies that tease apart these different factors that relate to brain decline, Stoeckel says.
So what does this cognitive decline look like in real life? It’s not as simple as occasionally forgetting where you left your keys or your phone — that can happen to anyone, especially as we get older.
What’s more concerning is if your brain glitches affect your daily living. For example, maybe you’ve worked in finance all your life and suddenly, you have trouble managing your checkbook or online banking.
It’s also a red flag if people around you notice differences in the way you think or manage things, Klingman says.
However, it’s tricky because some people can hide it well. “It can be easier for people who are very educated and articulate to hide their problem because to the people around them, they can still sound knowledgeable and well-spoken, and they can manipulate conversations better,” Young says.
Sometimes, people experiencing memory issues or brain decline will make up stories, become frustrated and afraid or just appear angry at others. “For example, if they misplace something, they may start accusing people of stealing their things or hiding them. If they get lost, they blame poorly labeled signs or bad directions,” Young says.
[See: 5 Ways to Cope With Mild Cognitive Impairment.]
It’s sometimes scary to see the lengths that a person with brain decline will go to hide their problems. Young tells the story of a patient who was no longer safe to be home alone and had trouble managing diabetes. “She would call me several times a week to tell me she thought she took the wrong insulin. Then she would come to the office — an hour late because she got lost every time — and have no recollection of the conversation,” Young says. Both the patient and her son insisted she was fine. It finally took several trips to the hospital to help the patient get the help she needed.
Young has also had patients who have forgotten whether they took their insulin and then take it again and end up in the hospital with low blood sugar. Diabetes is already hard to manage, but it can be dangerous with an impaired memory, she explains.
You may wonder if you’re at the same risk for brain decline if you take your diabetes medications as needed. The research in that area isn’t as clear, although it would make sense that better blood sugar control would have a reduced risk for conditions like dementia, doctors say. The National Institutes of Health is leading more research in brain decline and diabetes because of the need for better answers in this area, Stoeckel says.
What happens if you suspect that you or a loved one with diabetes is experiencing brain decline that’s beyond the norm? First, start with your primary care physician. He or she can conduct some simply neurological tests to see if memory or cognition are a problem. If so, you may need to be seen by a neurologist or neuropsychologist for more testing.
Unfortunately, there’s no cure yet for conditions like dementia or Alzheimer’s disease, although there’s a lot of research right now into treatments. However, earlier detection can possibly help prevent problems before they become overwhelming.
Here are a few steps you can take if you have diabetes and want to try to prevent any associated cognitive decline:
[See: 9 Habits That May Reduce Your Risk for Developing Alzheimer’s.]
Exercise regularly. You’ve heard that advice before, but now there’s another reason to make sure you get in the exercise routine. Not only does it help your physical health and your mood, but it can also boost your brain health. “Exercise is the single most effective intervention for the brain. So far, there’s nothing better,” says Dr. Christoph Buettner, professor of medicine, endocrinology, diabetes and bone Disease at the Icahn School of Medicine at Mount Sinai in New York.
Get your blood sugar under control. If you have Type 2 diabetes, this usually requires the use of medication, weight loss and adopting a low-sugar and low-carbohydrate diet, Klingman says.
Don’t be afraid to ask for help if you suspect you have memory or brain problems. “I plead with people to not be too proud to ask for help when you start to have issues with memory. It’s not safe to try to tough it out yourself,” Young says. “If you catch it early on, you can stave off adverse consequences,” Stoeckel says. Another reason it’s important to speak up: Symptoms of depression can sometimes resemble symptoms of dementia, so your doctor should be able to help make the right diagnosis.
Use tools to help manage your memory. Keeping lists and setting reminders are helpful, and puzzles and reading can help keep the mind sharp, Young recommends.
Try to get more sleep. Quality sleep can make a big difference in brain health, Buettner says. In addition to your primary care doctor, there are sleep physicians who can help you pinpoint sleep problems.
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Why Cognitive Impairment Is More Common When You Have Diabetes originally appeared on usnews.com