In a first-time study, researchers have revealed that people with diabetes who suffer from "diabetic foot" have significantly impaired cognitive function.
Researcher Rachel Natovich from Ben-Gurion University of the Negev (BGU) said that this study shows a clear correlation between diabetes and cognitive deterioration, adding "Diabetes is a multi-system condition that affects the brain, and the risk of a diabetic developing dementia is twice that of a 'normal' person. Diabetic foot is a symptom that the diabetes is causing deterioration of the entire cardiovascular system."
Diabetic foot is one of the most severe but also preventable long-term complications of diabetes mellitus. The symptoms appear as non-healing foot ulcers and necrosis and, if untreated, can lead to multiple amputations. The lifetime risk of a person with diabetes developing a foot ulcer could be as high as 25 percent.
There is no research focusing on the cognitive functioning of these patients, despite the fact that the micro and macro vascular changes underlying the diabetic foot are systemic, occurring in many different organs, including the brain, says Natovich, who conducted the study. "Presently, research regarding diabetic foot focuses mainly on epidemiology, prevention and ulcer treatment."
According to the research, those with diabetic foot remember less, have decreased concentration, difficulty with learning, decreased inhibition, slower cognitive and psychomotor responses, and decreased verbal fluency.
Natovich proposes practical changes to the treatment strategy, including:
- Patients with diabetic foot must be routinely monitored for cognitive changes.
- Early detection of cognitive decline will enable initiating proper intervention.
- Due to difficulties with memory, attention and executive functions, the family and healthcare provider must take a more active role in patient care.
- Patients with diabetic foot could benefit from participation in group treatment aimed at improving diabetic control, nutrition and physical activity.
Diabetic patients should receive psycho-education regarding possible cognitive complications of the disease and the importance of proper disease control for preservation of cognitive abilities.