No evidence that treatment or level of control of Type II diabetes influences cognitive function

Grimley Evans J, Areosa Sastre A

Published Online:

January 21, 2009

Type II diabetes is a chronic disease characterized by high blood glucose levels. It needs to be treated with diet, oral drugs and sometimes insulin to control symptoms and avoid organ damage. Patients may develop features of cognitive decline (e.g. memory problems) earlier than healthy people. This review tries to clarify whether the type of treatment or control of the glycemia influences cognitive function. None of the studies identified had sufficient high quality data to justify any conclusion. Future trials of treatment for Type II diabetes should include measures of cognitive function as an outcome.

Abstract (click to read)

Background:

There is increasing interest in preventing cognitive impairment and dementia in later life. Epidemiological evidence shows a relationship between cognitive impairment and Type II diabetes. This association is stronger in patients who have been diagnosed for longer periods of time and in those who are on insulin therapy. There is little information on the short- and long-term influence of type of treatment and level of metabolic control on cognitive function of people with diabetes.

Objectives:

To assess the effects of different types and intensities of treatments for Type II diabetes on cognitive function.

Search strategy:

The CENTRAL Register of Controlled Trials, MEDLINE, EMBASE, PsycINFO, SIGLE LILACS and CINAHL as well as a number of ongoing trials databases were last searched on 4 August 2005 using appropriate strategies.

Selection criteria:

Randomized controlled trials in which different treatments for Type II diabetes have been compared and in which measures of cognitive function were made at entry and after the treatment.

Data collection and analysis:

Two reviewers independently assessed trial quality. Five trials were identified for possible inclusion but none of them could be included. In one, cognitive function was assessed before and after intensive or conventional diabetic treatment, but the comparison was not double-blind. The three other studies explored the effect of different treatments on QOL but did not include appropriate evaluation of cognitive function. The fifth did not report baseline data on cognitive function in the trial groups.

Main results:

No studies were found to be appropriate for inclusion in meta-analysis.

Authors' conclusions:

There is no convincing evidence relating type or intensity of diabetic treatment to the prevention or management of cognitive impairment in Type II diabetes. Future research on treatments for diabetes should include standardized assessments of cognitive function as outcome measures.

This record should be cited as:

Grimley Evans J, Areosa Sastre A. Effect of the treatment of Type II diabetes mellitus on the development of cognitive impairment and dementia. Cochrane Database of Systematic Reviews 2003, Issue 1. Art. No.: CD003804. DOI: 10.1002/14651858.CD003804

Assessed as up to date:

August 4, 2005

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Primary Review Group:

Dementia and Cognitive Improvement Group

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

No evidence that treatment or level of control of Type II diabetes influences cognitive function

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