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According to the World Health Organization (WHO), more than 16 million Brazilian adults have type 2 diabetes, which is diabetes mellitus

A study carried out by a group of researchers from the School of Medicine of the Pontifical Catholic University of Paraná (PUCPR), published in the scientific journal Diabetology & Metabolic SyndroME, indicated a worsening of the cognitive deficit (learning difficulties) of patients with type 2 diabetes.



According to the World Health Organization (WHO), more than 16 million Brazilian adults have type 2 diabetes, which is diabetes mellitus (a disease characterized by increased blood glucose levels).



The Brazilian Society of Diabetes (SBD) reported that about 90% of patients have type 2 (DM2) of the disease, when the body cannot properly use the insulin it produces or does not produce the hormone sufficiently to control the rate of blood glucose. The disease has potential complications, including cognitive decline.



The evaluation of this problem led PUCPR researchers to study 250 adults with type 2 diabetes, patients at a university hospital. The survey was carried out between 2018 and 2021 and was delayed due to the covid-19 pandemic. PUCPR professor Ana Cristina Ravazzani de Almeida Faria, a doctoral student at the Postgraduate Program in Health Sciences, told Agência Brasil today (14th) that it was already known that patients with diabetes have, over time, a deficit of greater cognition or more likely to have a cognition deficit than people without diabetes.



conclusions


“What we were looking for was whether among these diabetics we could identify who would be more likely to have this cognitive deficit or greater chances of evolving, over time, to a greater cognitive decline than the rest of the group”, said Ana Cristina. .



Physicians and medical students who participated in the research concluded that the most susceptible patients are people with low education, over 65 years old, with more than 10 years of diabetes and who already have a cardiovascular disease, as a consequence or not of diabetes, and who have diabetic retinopathy. In addition, patients with symptoms of depression are also more susceptible.



“We managed to identify, within the group, the sector with the greatest risk”, he specified. Of the total of 250 patients investigated, 14% had worsened cognition in the 18 months of the study. An initial assessment of the patients was carried out and, after a year and a half, on average, a new assessment was carried out. “This subgroup of 14% had the worst performance”, highlighted Ana Cristina.



During routine consultations and follow-up, patients underwent physical examination, screening for symptoms of depression, and cognitive tests, including mini mental status examination, semantic verbal fluency test, A and B trail test, and memory memory test. words. Demographic data, such as age and education, linked to lifestyle and duration of diabetes, were also analyzed.



Cognitive assessment


International guidelines recommend that patients over 65 years of age should undergo a cognitive assessment, because it is known that there is a greater risk and that cognitive deterioration can interfere with quality of life and self-care.



Ana Cristina said, however, that public hospitals have greater difficulty in carrying out this type of assessment with all patients, including because they are referred for a cognitive assessment only when they have a complaint, such as memory loss, for example.



“But all the patients we evaluated had no complaints and said they were fine. Or that they had a very vague complaint. They had no previous evaluation or diagnosis of cognitive dementia. Whoever had this didn’t even enter the research”, he guaranteed.



The researchers suggest that people with type 2 diabetes have at least one cognitive assessment per year after age 60 or 65, which is the most affected age group. The research group continues to follow the patients who were part of the first study, expanding to the others. “We want to make this part of our service routine. This is our initial plan,” he said.



Patients initially evaluated will be re-examined to see if anyone has worsened or if there has been any improvement. This new investigation will be monitored by the neurology sector.



The goal is to get a larger universe of patients, in addition to continuing to follow up those who were part of the first study, at least once a year. The team also wants to partner with psychology professionals, who have an area called neuropsychology, which applies cognition tests.



“We are looking to form a partnership so that they can participate”. The new stage of the study, already with the area of ​​psychology included, should start in 2023.



Risk factors


Some risk factors are related to habits, such as smoking and physical inactivity, whose control could minimize the impact of the disease on cognition. As lower levels of education also reflect on the cognitive deficit of patients with type 2 diabetes, the researchers pointed out that it is essential for the Government to make more and more investments in education.



In addition to Ana Cristina Ravazzani de Almeida Faria, researchers from the PUCPR School of Medicine Joceline Franco Dall’Agnol, Aline Maciel Gouveia, Clara Inácio de Paiva, Victoria Chechetto Segalla and Cristina Pellegrino Baena signed the work.



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