A comparative study of impact on cognitive function between diabetic and non-diabetic patients in a tertiary care hospital

Dharnaben A. Patel, Dhruv J. Patel, N. D. Kantharia


Background: Diabetes Mellitus is a chronic metabolic disorder characterized by hyperglycemia, polyuria, hyperlipidemia etc, resulting from defects in insulin secretion, insulin action or both. It affects various organs of the body including the brain. Cognitive function is the thinking process of the brain. In any chronic disease evaluation of cognitive function is justified as it may affect various common day to day activities.

Methods: It is a prospective, observational and non-interventional study. Thirty diabetic patients who were recently started on insulin i.e. within 7 days were enrolled in the study based on inclusion and exclusion criteria. Thirty non diabetic healthy individuals served as a control. Cognitive function was accessed by Adenbrooke’s Cognitive Examination (ACE III) at the time of enrollment.

Results: The results were analysed using paired t-test. Attention, Memory and Visiospatial ability was significantly reduced in diabetic patients compared to control. Verbal fluency and language was also reduced but the change was not significant. Total ACE III score was significantly reduced in diabetic patients compared to control.

Conclusions: Cognitive function is significantly reduced in Diabetic patients recently started on insulin. Hyperglycemia could be the possible reason of cognitive decline. Proper understanding of the natural history of Diabetes and the pathogenesis of cognitive decline as well as control of Diabetes can help to prevent development of cognitive dysfunction.


Adenbrooke’s cognitive examination, Cognitive function, Diabetes mellitus

Full Text:



Arshiya TNA. A Study of Frequency and Factors Associated with Depression among Adult Diabetics in Urban Areas of Davangere, Karnataka. National J of Comm Medic. 2016;7(2):111-5.

Kaveeshwar SA, Cornwall J. The current state of diabetes mellitus in India. The Australas Med J. 2014;7(1):45.

Michael J. Fowler M. Microvascular and Macrovascular Complications of Diabetes. American Diabetes Association Clinical Diabetes. 2008;26(2):77-82.

Mittal S, Verma P, Jain N, Khatter S, Juyal A. Gender based variation in cognitive functions in adolescent subjects. Annals of neurosciences. 2012 Oct;19(4):165.

Caputo JB, Vagula MC. Cognitive impairment and dementia in Type 2 diabetes mellitus. US Pharm. 2014;39(10):33-7.

Feinkohl I, Price JF, Strachan MWJ, Frier BM. The impact of diabetes on cognitive decline: potential vascular, metabolic, and psychosocial risk factors. Alzheimer's Research and Therapy. 2015;7(1):46.

Zhang H, Hao Y, Manor B, Zhang J, Fang J, Novak V, et al. Altered Resting-State Connectivity of Hippocampus with Default Mode Network In Type 2 Diabetes. Joint Annual Meeting ISMRM – ESMRMB; 2014.

Shemesh E, Rudich A, Harman-Boehm I, Cukierman-Yaffe T. Effect of intranasal insulin on cognitive function: a systematic review. The J of Clin Endocrinol and Metabol. 2012;97(2):366-76.

Brands AM, Biessels GJ, de Haan EH, Kappelle LJ, Kessels RP. The effects of type 1 diabetes on cognitive performance: a meta-analysis. Diabetes Care. 2005;28(3):726-35.

Messier C. Impact of impaired glucose tolerance and type 2 diabetes on cognitive aging. Neurobiol Aging. 2005;26 Suppl 1:26-30.

McCrimmon RJRC, Frier BM. Diabetes and cognitive dysfunction. Lancet. 2012;S0140-6736(1012):60360-2.

Tuma I. Diabetes mellitus and cognitive impairments. Vnitrni lekarstvi. 2007;53(5):486-8.

Kodl CT, Seaquist ER. Cognitive Dysfunction and Diabetes Mellitus. Endocrine Reviews. 2008;29(4):494-511.

Goldman E. How hyperglycemia drives cognitive dysfunction. Holistic primary care News for health and healing; 2013.

Brownlee M. The pathobiology of diabetic complications: a unifying mechanism. diabetes. 2005 Jun 1;54(6):1615-25.