Patients with diabetes, determined by higher HbA1c levels, show greater increases in cognitive decline over 10 years compared to those with normal blood sugar, suggesting that good blood glucose control could help slow possible progression to dementia.
As there is currently no cure for dementia, interventions that delay diabetes onset, as well as management strategies for glucose control, might help to reduce the progression of cognitive decline over the long term.
In terms of possible underlying mechanisms of the link between diabetes and cognitive decline, some evidence points to glycemic fluctuation as having a stronger effect on cognitive decline compared with sustained high blood sugar, possibly through induction of oxidative stress and increasing microvascular disease of the central nervous system.
In addition, diabetes has been linked to cognitive impairment through direct mechanisms, such as inducing amyloid accumulation thereby potentially playing a key role in vascular dementia.
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