Neurocognitive functioning in type 1 and type 2 diabetes mellitus

Abstract

Neuropsychology traditionally studies the effect of neurological diseases, such as stroke and dementia, on cognitive functioning. The focus on non-neurological diseases, including diabetes, has grown over the last decades. In this chapter we summarize the current literature with respect to cognitive functioning in patients with type 1 and type 2 diabetes. Both types of diabetes seem to affect similar cognitive domains with similar effect sizes. Risk factors largely pertain to the effects of chronic hyperglycemic exposure, macrovascular comorbidity, and psychiatric conditions. With the rapidly increasing prevalence of diabetes and life expectancy, the development of dementia is important to take into account. We therefore discuss the current understanding of the relationship between diabetes and dementia and how antidiabetic medication may have a protective effect. In the last sections, we will detail the clinical relevance of cognitive decrements found in studies and what we think are the most important future questions to be answered.