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Diabetologia. 2020 Jan;63(1):3-9. doi: 10.1007/s00125-019-04977-9. Epub 2019 Aug 16.

Cognitive dysfunction in diabetes: how to implement emerging guidelines.

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Department of Neurology, G03.232, UMC Utrecht Brain Center, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, the Netherlands.
Department of Public Health Sciences, Division of Epidemiology, Population Brain Health Laboratory, University of California Davis, Davis, CA, USA.


Cognitive dysfunction, including mild cognitive impairment and dementia, is increasingly recognised as an important comorbidity and complication of diabetes that affects an individual's well-being and diabetes management, and is associated with diabetes treatment-related complications. Recent guidelines therefore recommend screening for cognitive impairment in older individuals with diabetes. In addition, these guidelines suggest that glucose-lowering treatment should be tailored in those diagnosed with cognitive impairment, to reduce the risk of hypoglycaemia and improve treatment adherence. This review gives an overview of cognitive dysfunction in people with diabetes, briefly describing the clinical features of different stages of cognitive dysfunction and their epidemiology. In particular, it addresses essential additional steps that need to be taken to fully implement the emerging guidelines on screening and management of cognitive dysfunction in diabetes into daily practice.


Alzheimer’s disease; Cognitive dysfunction; Dementia; Guidelines; Implementation; Mild cognitive impairment; Review; Screening; Type 1 diabetes; Type 2 diabetes

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