The effects of acute hypoglycaemia on cognitive function in type 1 diabetes

Abstract

Throughout life with type 1 diabetes mellitus people with the condition are exposed to multiple episodes of hypoglycaemia associated with insulin therapy. Hypoglycaemia affects several domains of cognitive function. Studies in non-diabetic adults and in people with type 1 diabetes have shown that almost all domains of cognitive function are impaired to some degree during acute hypoglycaemia, with complex tasks being more greatly affected. The specific cognitive functions of attention and memory are both profoundly impaired during hypoglycaemia. These cognitive processes are fundamental to the performance of many day to day tasks. Their impairment disrupts everyday life and raises safety concerns for the pursuit of activities such as driving. Mood and emotion are also negatively affected by hypoglycaemia, resulting in tense tiredness, while motivation is reduced, and anger may be generated in some individuals. Hypoglycaemia can cause embarrassing social situations, and may lead to chronic anxiety and depression in people with type 1 diabetes. At present few therapeutic measures can modify or ameliorate the effects of hypoglycaemia on cognitive function, so instigation of measures to prevent exposure to hypoglycaemia is of major clinical importance, while preserving good glycaemic control.