Project 4
The goal of The Glucose Regulation and Cognitive Function in Type 2 Diabetes Project is to better understand the association between exposure to hypoglycemia and hyperglycemia and momentary cognitive function and risk for ADRD.
Overview
Having diabetes, including experiencing high or low blood sugar, has been linked to difficulties with learning, memory and attention and a long-term risk of developing Alzheimer’s disease in older adults. Few studies have looked at the relationships between high and low blood sugar in a more fine-grained manner using continuous glucose monitoring (CGM). We will ask participants with diabetes to wear a CGM device on their upper arms to measure and record blood sugar levels at very frequent intervals. If prescribed a diabetes medication, participants will also be asked to use a study medication bottle to track medication-taking routines. Participants will also be asked to complete daily and annual measures specific to the experience of having diabetes. This detailed data will provide the opportunity to better understand how diabetes and blood sugar levels impact learning, memory and attention over time, which can influence clinical care guidelines and the development of interventions to improve the lives of older adults with diabetes.
With our aging population and expanding obesity epidemic, the importance of type 2 diabetes (T2D) as a remediable risk factor for cognitive decline has expanded, particularly in underserved communities. T2D is a risk factor for Alzheimer’s disease and related dementias, vascular dementia, mild cognitive impairment and accelerated cognitive decline. Despite abundant evidence linking T2D to cognitive outcomes, research has failed to show that tight blood glucose (BG) control reduces the risk of cognitive decline. This evidence may be limited by use of BG measures that do not capture BG variability and hypoglycemia.
The Diabetes Project will provide new data linking dynamics in cognitive functioning and BG metrics through innovative pairing of mobile cognitive assessments and continuous glucose monitoring (CGM) among EAS participants with T2D. This project will evaluate relationships between hyperglycemia, hypoglycemia and BG variability and contemporaneous performance on mobile cognitive tests. Performance on a clinic based neuropsychological testing battery will also be examined in relation to these BG metrics. We will also examine biobehavioral mediators and moderators of these relationships. Ultimately, this work will facilitate the tailoring of glycemic goals according to individual patient characteristics and inform the development of innovative just-in-time adaptive interventions to optimize cognitive function for adults with T2D.
To view the full abstract and further project details from NIH RePORTER, click here.