Study: No cognitive benefit with tight blood-glucose control

WINSTON-SALEM, N.C. — Intensive control of blood-sugar levels beyond standard targets provides no additional protection against cognitive decline in older people with diabetes than standard treatment, according to a national study coordinated by researchers at Wake Forest Baptist Medical Center that was published online in the The Lancet Neurology.

"We know that people with Type 2 diabetes have a much higher risk of dementia and memory loss than people without diabetes," stated Jeff Williamson, chief of the Department of Geriatrics and Gerontology and principal investigator of the study's coordinating center at Wake Forest Baptist. "What we didn't know was, if you intensively control blood-sugar levels in people who have had a history of trouble controlling them, does the added cost and effort to control blood sugar result in a slowed rate of memory loss? After conducting this study, there remains no evidence that it does," he said.

"We also learned, however, that the intensive blood-sugar control does preserve brain volume," Williamson added. "What that means for the long term preservation of cognitive function of these patients, we're still trying to figure out."

The ACCORD-MIND trial is a national study sponsored by the National Heart Lung and Blood Institute — part of the National Institutes of Health — designed to examine the effects of different glucose-lowering strategies on the risk for cardiovascular disease.

"While these findings do not support the use of intensive therapy to reduce the possible effects of diabetes on the brains of older people, it remains important for older adults with Type 2 diabetes to continue well-established regimens to keep their blood-glucose levels under control," noted lead author Lenore Launer, of the National Institute on Aging. "Cognitive health is of particular concern in Type 2 diabetes. We will continue to investigate how managing blood sugar levels might be employed to protect people with diabetes from increased risk of cognitive decline as they age."

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