During a Tuesday morning symposium, four researchers will explore the effects of cognitive decline and aging as it relates to diabetes care. They will discuss the psychosomatic effects of out-of-control diabetes and hypoglycemia in conjunction with aging, how to recognize the symptoms of cognitive decline, and what can be done to ensure patients still safely manage their disease.
The two-hour symposium, Cognitive Decline—Recognizing and Adapting Diabetes Care Strategies, begins at 7:30 a.m. in room 23.
Alan M. Jacobson, MD, Chief Research Officer at New York Winthrop-University Hospital and Emeritus Professor of Psychiatry at Harvard Medical School, will discuss the effects type 1 and type 2 diabetes have on neurocognitive problems in aging. His 30-minute lecture asks the question: “Does Diabetes Cause Cognitive Decline?”
“There are a lot more questions than answers,” Dr. Jacobson said. “There’s more information known for type 2 diabetes and its effects on neurocognition as it relates to older people. Now, people with type 1 diabetes are living longer, healthier lives so we are in a position to examine how the brain gets affected.”
Research suggests that thinking processes slow faster in people with type 1 and type 2 diabetes, and that people with type 2 diabetes may be at higher risk for formal dementias, Dr. Jacobson said. Whether these are Alzheimer’s disease or vascular dementias remains unclear, he said, but more than likely they are a combination of multiple factors and effects.
“Just because you see changes in the brain doesn’t mean you’re going to see a dementia,” Dr. Jacobson noted. “But there are some hints that hypoglycemia may be a risk factor for cognitive problems in both type 1 and type 2 diabetes.”
The effects of hypoglycemia are being examined in Epidemiology of Diabetes Interventions and Complications (EDIC), a study designed to assess the incidence and predictors of cardiovascular disease events, Dr. Jacobson said. It’s a follow-up to the Diabetes Control and Complications Trial, which was funded by the National Institute of Diabetes and Digestive and Kidney Diseases and demonstrated that keeping blood glucose levels close to normal slows the onset of eye, kidney, and nerve damage caused by type 1 diabetes.
Following Dr. Jacobson’s lecture, Peggy Soule Odegard, BSPharm, PharmD, CDE, Professor and Associate Dean of the School of Pharmacy at the University of Washington, will discuss clinical strategies to reduce hypoglycemia and simplify diabetes care for patients with cognitive decline.
Next up, Deborah A. Hinnen, APN, BC-ADM, CDE, FAAN, Advanced Practice Nurse and Certified Diabetes Educator at Memorial Hospital Diabetes Center at the University of Colorado Health, will share tips and self-management strategies to help diabetes patients maximize their care. She will review specific approaches such as the teach-back method to help patients with cognitive decline verify their medication administration or glucose-monitoring skills.
Whether a patient has cognitive decline or not, diabetes is overwhelming, Hinnen said. It requires glucose monitoring, healthy eating, daily administration of multiple oral and injectable medications and potentially multiple insulin injections, and counting carbohydrates. That’s why it’s important to implement reminders, verify skills, and include care partners in education, she said.
“We have to rethink our time together with patients because they may not remember it later,” Hinnen said. “Even if we have their agreement in a shared decision plan, we can’t just tell them what to do. And writing it down may not be enough.”
Jose A. Luchsinger, MD, MPH, Associate Professor of Medicine and Epidemiology in the Department of Medicine at Columbia University, will open the session with a 30-minute introductory lecture titled “The Realities of Aging.”