Short-Term, Delayed, and Working Memory Are Impaired During Hypoglycemia in Individuals With Type 1 Diabetes

Author:

Sommerfield Andrew J.1,Deary Ian J.2,McAulay Vincent1,Frier Brian M.1

Affiliation:

1. Department of Diabetes, Royal Infirmary of Edinburgh, Edinburgh, Scotland, U.K.

2. Department of Psychology, University of Edinburgh, Edinburgh, Scotland, U.K.

Abstract

OBJECTIVE—To examine the effects of acute insulin-induced hypoglycemia on short-term, delayed, and working memory in individuals with type 1 diabetes. RESEARCH DESIGN AND METHODS—A hyperinsulinemic glucose clamp was used to maintain arterialized blood glucose level at either 4.5 mmol/l (euglycemia) or 2.5 mmol/l (hypoglycemia) on two separate occasions in 16 adults with type 1 diabetes. The participants completed tests of immediate and delayed verbal memory, immediate and delayed visual memory, and working memory during each experimental condition. Two other mental tests, the Trail Making B Test and the Digit Symbol Test, were also administered. RESULTS—Performance in tests of immediate verbal and immediate visual memory was significantly impaired during hypoglycemia. The effect of hypoglycemia on working memory and delayed memory was more profound. Performance in the nonmemory tests, the Trail Making B Test, and the Digit Symbol Test also deteriorated during hypoglycemia. CONCLUSIONS—All of the memory systems examined in the present study were affected significantly by acute hypoglycemia, particularly working memory and delayed memory. Mild (self-treated) hypoglycemia is common in individuals with insulin-treated diabetes; therefore, these observed effects of hypoglycemia on memory are of potential clinical importance because they could interfere with many everyday activities.

Publisher

American Diabetes Association

Subject

Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine

Reference46 articles.

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2. Pramming S, Thorsteinsson B, Bendtson I, Binder C: Symptomatic hypoglycaemia in 411 type 1 diabetic patients. Diabet Med 8: 217–222,1991

3. Deary IJ: Effects of hypoglycaemia on cognitive function. In Hypoglycaemia and Diabetes: Clinical and Physiological Aspects. Frier BM, Fisher BM, Eds. London, Edward Arnold, 1993, p.80–92

4. Kerr D, Macdonald IA, Tattersall RB: Patients with type 1 diabetes adapt acutely to sustained mild hypoglycaemia. Diabet Med 8: 123–128,1991

5. Hoffman RG, Speelman DJ, Hinnen DA, Conley KL, Guthrie RA, Knapp RK: Changes in cortical functioning with acute hypoglycemia and hyperglycemia in type 1 diabetes. Diabetes Care 12: 193–197,1989

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