Date of Graduation

8-14-2010

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

Anya Hill, PA-C, MS

Second Advisor

Annjanette Sommers MS, PAC

Third Advisor

Rob Rosenow PharmD, OD

Abstract

Background: Diabetes is a prevalent chronic illness, affecting up to 23.6 million people in the United States. The association of diabetes and cognitive dysfunction is well recognized, and many have suggested memory to be among the cognitive functions most affected. The proposal of chronic hyperglycemia having a negative effect on cognition independent of other risk factors has yet to be determined.

Methods: An extensive literature search was performed using Medline, CINAHL, and Web of Science databases. Titles and abstracts were screened for relevancy and discarded if clearly not eligible. The full text of potential studies was reviewed for at least one objective measurement of memory in type II diabetic participants with correlation to level of control as measured by HbA1c. The references of selected studies and review articles were evaluated for additional publications.

Results: The majority of reviewed studies did not find a significant association between HbA1c and performance on tests of verbal and visual memory. Extensive variation in study design was found including control over confounding factors and selection of cognitive testing.

Conclusion: Studies on the relationship between level of control of diabetes and cognition are both limited and confounded by lack of control of comorbitities within study designs. Further research within carefully designed longitudinal studies is necessary to better understand any existing relationship between level of glucose control and cognition, and may spotlight the need for specialized education and support regarding disease self-management for people with type II diabetes.

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