The mind matters, doesn’t it? In that case, you need to know, 'how does diabetes affect intellectual development?'
Why are we saying this? Out of the blue?
No. It is because diabetes is a quiet, unsensational pandemic that it is increasingly affecting millions around the world. World Diabetes Day is on November 14. What better time to unravel the mystery surrounding diabetes?
So, we thought it'd be a good idea to bring this chronic disease to the limelight to create more awareness about dysfunction in patients.
Table of Contents
What is Diabetes?
Diabetes is a chronic medical condition that affects how your body processes glucose, a type of sugar and a primary energy source for your cells. There are two main types of diabetes: type 1 and type 2.
Type 1 diabetes is characterized by the immune system attacking and destroying insulin-producing cells in the pancreas, requiring insulin injections. Type 2 diabetes is often associated with insulin resistance, where the body's cells do not respond effectively to insulin. Gestational diabetes can occur during pregnancy when the body cannot produce enough insulin.
American Diabetes Association has set up the criteria and symptoms.
Complications of Diabetes
High levels of glucose in the blood can lead to various health complications, including vascular disease risk, cerebrovascular disease, cardiovascular disease, nerve damage, kidney disease, and vision issues. Strategies for people with type 2 diabetes involve sugar monitoring, medication, dietary changes, and regular physical activity to maintain glycaemic control within a target range.
Elevated blood glucose levels can cause health complications such as cardiovascular issues, nerve damage, kidney disease, and vision problems. Diabetes management involves monitoring, medication, dietary changes, and regular physical activity to maintain blood sugar levels to reduce complications.
How Does Diabetes Affect Intellectual Development?
Researchers studied cognitive differences and corresponding brain structural effects in children with type 1 diabetes. They also examined the effects of extreme blood sugar levels on specific brain regions in young people with type 1 diabetes.
The effects of type 1 show the impact on the mental development of children, leading to cognitive challenges and academic difficulties. Collaboration between healthcare professionals, parents, and educators is crucial to ensure children with diabetes receive the necessary support. Dementia in diabetes mellitus patients can occur in adults and seniors. Diabetic retinopathy and systolic blood pressure are independent risk factors for cognitive decline in diabetes.
Early-onset diabetes before age 5 leads to lasting cognitive deficits into adulthood. Youth with type 1 diabetes have slightly lower cognitive function, particularly in executive functions, learning, memory, and processing speed. Some exhibit more significant differences due to early onset and glycemic fluctuations. Further research is needed.
Youth with type 1 diabetes are linked to cognitive decline in adulthood, affecting fluid cognition, processing speed, executive functioning, and memory. Early-onset diabetes is associated with lower intellectual and processing abilities. High or low blood glucose levels can cause vascular risk factors, contributing to cognitive dysfunction. Extreme blood sugar levels that require hospitalization worsen impairment to dementia.
Brain MRIs have found an association between diabetes age of onset and dementia, but the underlying pathophysiology is not well understood. Patients with type 2 diabetes experience impaired cognitive performance and abnormalities on brain magnetic resonance imaging due to metabolic and microvascular dysfunction.
The ACCORD (memory in diabetes—MIND) study did not find cognitive function benefits from intensive control in T2DM (type 2 diabetes mellitus) diagnostic criteria. Severe hypoglycemia may cause a decline in cognitive functioning and may predict hospitalization.
Memory problems in adults with type 2 are commonly observed. They may also have problems with executive function (a set of cognitive processes responsible for planning, organizing, initiating, and regulating goal-directed behaviour) and psychomotor speed (ability to perceive, process, and respond to sensory stimuli quickly and accurately).
Many may experience a long-term decline in patients' cognition following recurrent episodes of severe hypoglycemia.
The research so far has arrived at the findings above. However, more rigorous future directions are required to establish facts and figures on impairment in individuals. Factors for dementia, once established after stringent peer reviews and acceptance by the authorities concerned, will improve the lives of unhealthy and healthy subjects.
Ill Effects of Diabetes in Children
Children are vulnerable to a host of infections and diseases as they are still in the developmental stage of immunity. Here are some negative impacts of type 1 diabetes:
Developmental Delays: Chronic high blood sugar levels in children with type 1 diabetes can impact their intellectual and cognitive development. Growing brains need to receive adequate glucose and nutrients. Prolonged hyperglycemia may interfere with this process, leading to developmental delays.
Diabetes can damage brain vessels, causing memory, learning, attention, reasoning, and decision-making issues. It increases the risk of dementia, Alzheimer's, and vascular dementia, especially in older adults.
Academic Performance: Some children and adolescents with diabetes may experience difficulties in school due to the challenges of managing their condition. Fluctuations in blood sugar levels can affect their concentration and ability to focus, which can, in turn, impact their academic performance.
Brain regions have distinct functions, controlling cognitive processes like memory, attention, language, and decision-making. Examples include the prefrontal cortex, hippocampus, amygdala, and cerebellum, all needing stimulation to grow effectively.
Behaviour and Social Skills: Diabetes management can sometimes be stressful for young individuals. Coping with the demands of blood sugar monitoring, insulin injections, and dietary restrictions can affect a child's behaviour and social skills.
Since the disease pertains to metabolic control, high or low blood sugar levels can sometimes affect learning, cognition, attention, and behaviour. Stress, school social events, and hormones can further complicate diabetes management. Children with diabetes may have more absences due to hospital appointments or illness. Schools play a crucial role in providing support and resources for diabetes management.
It's essential to note that the impact of diabetes on mental development varies from person to person. Many children and adolescents with type 1 diabetes lead normal lives and perform well academically. Proper management of the condition, including regular blood sugar monitoring, insulin administration, and a healthy lifestyle, can significantly reduce the risk of these potential effects and improve brain function.
It's also crucial for parents and healthcare providers to provide appropriate support and guidance to help children and adolescents with diabetes thrive in all aspects of their development and become healthy individuals.
Schools can play a crucial role in supporting students with diabetes by implementing several strategies:
Develop a Diabetes Care Plan: Schools should create a comprehensive plan for students with diabetes, including emergency contacts and instructions for managing diabetes-related emergencies. This plan should be shared with all relevant school personnel.
Promote Healthy Eating: Schools can encourage students to choose healthy food and offer nutritious meals, including a balanced breakfast. Collaboration between students and parents on meal planning can be beneficial.
Support Physical Activity: Diabetes shouldn't deter students from engaging in physical activities or physical education classes. Encouraging at least 60 minutes of daily physical activity can help improve blood sugar control.
Monitor Vaccinations: Schools should ensure that students with diabetes receive all recommended vaccinations, including the flu shot, as illnesses can affect blood sugar control and cause poorer performance.
Emphasize Hand Hygiene: Encouraging regular handwashing, especially before eating or handling food, helps prevent infections that can affect glycemic control and avoid the onset of diabetes.
Personalized Diabetes Medical Management Plan (DMMP): Parents and schools can collaborate to create a personalized DMMP outlining diabetes management and treatment, including how to recognize and address high or low blood sugar levels. This plan should be shared with relevant school staff. Periodical neuropsychological tests can be done to track brain function progress.
Coordination and Collaboration: Effective coordination and collaboration among the school health team and the student's personal diabetes healthcare team is essential for managing diabetes at school. This teamwork involves parents, school personnel, and healthcare providers to help students with diabetes succeed in their educational attainment.
By implementing these strategies, schools can create a supportive environment for students with glycemic episodes. Hyperglycemic episodes denote high blood sugar levels, and hypoglycemic episodes point to low blood glucose levels.
Through this extensive blog on 'How does diabetes affect intellectual development?', we learnt that diabetes is a chronic condition that affects the body's ability to process glucose, the primary energy source for the brain. It can lead to cognitive deterioration, mood disorders, and developmental delays in children and adolescents. Poor cognition is more commonly linked to glycemic extremes than other aspects of the metabolic syndrome.
Damaged blood vessels due to a lack of cerebral blood flow can cause memory, learning, attention, reasoning, and neurocognitive dysfunction, increasing the risk of dementia, Alzheimer's disease, and vascular dementia. Hormonal imbalances, inflammation, and oxidative stress can also affect mood and mental health. However, some studies show no significant differences in IQ, mood, or learning abilities in children with diabetes compared to those without.
How does diabetes duration affect patients - children, youth, and the elderly?
Duration of diabetes causes impairment in patients' cognition at all ages, especially in the elderly. Early diagnosis and treatment may prevent or delay cognitive decline. More research is needed on the 'age at onset' of diabetes and youth cognition.
How can patients with type 1 manage stress and anxiety related to diabetes?
Diabetes stress management: exercise, relaxation, positive attitude, healthcare support, stress coping, blood sugar control, mindfulness, breaks, a healthy diet, medication, and professional help.
What did the research studies conclude about cognitive decline in individuals with diabetes?
The following are some of the conclusions of previous studies of people with diabetes:
Exercise and cognitive training improve children's cognition. Factors for dementia in senior people's cognitive decline are unclear. Gray matter volume is linked to memory, attention, and decision-making. Type 1 diabetes affects cerebral white matter volume and cognition.
Longitudinal studies on diabetes' effects on cognitive function show an increased risk of cognitive impairment and dementia progression. However, studies in children and adults show cognitive deficit progression over time, emphasizing the importance of the disease's duration.
In cross-sectional studies by Wredling et al. (59) and Langan et al. (60), recurring episodes of severe hypoglycaemia were associated with poorer cognitive test results. Newer treatment strategies might be associated with delayed onset and a reduced degree of cognitive performance; however, this concept requires verification in future studies. (Source: academic.oup.com)
A prospective study found that individuals with type 2 diabetes experienced an accelerated progression of brain atrophy and white matter metalloproteinase (WML) over 3–4 years.
Observational studies have found that diabetes is linked to cognitive decline, dementia, and mental disorders. Severe hypoglycaemia's negative impact on cognition is unclear. More research is needed to understand clinical implications.