Link Identified Between Diabetic Peripheral Neuropathy And Cognitive Decline

A recent study in the Journal of Diabetes and its Complications found an association between diabetic peripheral neuropathy (DPN) and cognitive decline.¹ Participants in the Glycemia Reduction Approaches in Diabetes (GRADE) study were the cohort for this particular investigation. This included 5,047 individuals of middle age, with type 2 diabetes for less than 10 years known duration. Researchers assessed verbal learning, immediate and delayed recall, executive function, processing speed, concentration and data organization. They determined status with regard to DPN with the Michigan Neuropathy Screening Instrument and cardiovascular autonomic neuropathy with heart rate variability indices.¹

The authors looked at both DPN and cardiovascular autonomic neuropathy in relation to cognitive impairment. They found a significant inverse association between DPN and testing of immediate recall and processing speed. Correlating factors noted in the study included higher urine albumin creatinine levels and waist circumference. Autonomic neuropathy did not seem to have a consistent association with cognitive measures. The authors acknowledge that the root mechanism behind this association with DPN and cognition is not yet known.¹

These findings by Barzilay and colleagues provide vital information to us as providers, in that it even further supports the widespread impact of diabetes and its complications. I believe strongly that this should all of us further impetus to focus on patients’ behavior and intervening when necessary for education and counseling.

Dr. Armstrong is Professor of Surgery at the Keck School of Medicine at the University of Southern California. He is the Director of the Southwestern Academic Limb Salvage Alliance (SALSA). 

Editor’s note: This blog originally appeared at: https://diabeticfootonline.com/2021/11/23/diabetic-peripheral-neuropathy-linked-to-cognitive-decline-in-type-2-diabetes/ . It is adapted with permission from the author.

Reference

1. Barzilay JI, Ghosh A, Busui RP, et al. The cross-sectional association of cognition with diabetic peripheral and autonomic neuropathy – the GRADE study. J Diabetes Complic. 2021;35(12):108047.