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Saving our Brains

Many of us who have diabetes are more in tune with our minds than our bodies. We are “not athletic.” Many of us will frankly acknowledge that we are “into our heads.”

Now its clear that we can’t have a good head on our shoulders without having good shoulders and all. Our diabetic body will give us a diabetic mind — if we let it. And when we control our diabetes, not only our bodies but also our brains work better.

A diabetic body has high blood glucose. When we succeed in bringing our blood glucose level down to normal, our bodies aren’t diabetic any more. When our diabetes is controlled, it may not be cured, but it’s certainly in such remission that no tests would show that it’s diabetic.

The only thing then that would prove we still have diabetes is to revert to our old ways. Don’t try this at home — or anywhere else.

A diabetic mind functions just like a diabetic body. Poorly.

Since our brains live or die on glucose, when we think about it, we aren’t surprised that diabetes affects our brains too. Diabetes means that the glucose we take in stays in our bloodstream and doesn’t get to the cells that need them. And none of the cells in our bodies need glucose more than our brain cells.

This is all pretty logical. Even 2,000 years ago the Roman poet Juvenal thought that we needed to have a sound body to have a sound mind. Since his command of the English language was limited, he wrote “mens sana in corpore sano.” But where’s the proof of this idea?

We have that proof now. The journal Diabetes Care in its February issue just published the results of a huge study linking higher blood glucose levels to lower brain function. The journal thinks that the study is so important that it made the full-text free online.

Try to overlook the overly cute acronym for the study — ACCORD-MIND. Memory in Diabetes (MIND) is a sub-study of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial.

As our blood glucose levels go up our cognitive functioning drops. Researchers administered a battery of four different cognitive tests to 2,977 people who had type 2 diabetes. A 1 percent increase in the A1C levels of the participants in the study led to a statistically significant reduction in psycho-motor speed, global cognitive function, memory, and multiple task management.

Specifically, a 1 percent higher A1C level was associated with a 1.75-point lower score on the Digit Symbol Substitution Test, a 0.20-point lower score on the Mini Mental Status Examination, a 0.11-point lower memory score on the Rey Auditory Verbal Learning Test, and a worse score on the Stroop Test.

The mean A1C level of the people in the study was high — 8.3 percent– and the trial excluded people whose most recent A1C was less than 7.5 percent. The authors admit that the results might not apply to people who have lower A1C levels. Of course they don’t.

Maybe this study sounds like more bad news for people with diabetes. But even with impaired brains we can see that the reverse is true — the better we control blood glucose levels in our bodies the better our brains will function. What goes up can and will go down.

This article is based on an earlier version of my article published by HealthCentral.

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