How can diabetes affect the brain and psyche?

Having diabetes often means stress, because it places daily demands on those affected. People with diabetes must always adhere to rules, such as regular blood sugar testing, paying to attention to their diet and trying to get enough physical activity. Many of those affected suffer because the disease determines their daily life. This is coupled with a fear of developing complications. These perpetual demands can become a permanent emotional burden and place the patient in a state of constant stress. This is known by specialists as diabetes distress.

When subjected to constant stress, the body produces increased levels of the hormone cortisol. Cortisol also increases the blood sugar level to help provide the body with more energy quickly and when needed. Additionally, being under high levels of stress increases the release of the appetite hormone ghrelin. This appetite hormone increases the desire for sweet and carbohydrate-rich foods, making the blood sugar levels likely to rise even further due to the increased food intake.

A number of investigations have shown that diabetes distress often leads to the patient taking less care of themselves. Sooner or later, this affects the success of the treatment. The diabetes is neglected, metabolic control deteriorates, and the risk of long-term complication increases.

The good news: There are many learnable methods and measures to help reduce distress. One example is regular physical activity. It is crucial to seek and accept help. For example, strategies for coping with stress can be helpful.

There are many potential causes of increasing forgetfulness or difficulty concentrating. There is not always a serious underlying condition in these cases. Everyone has experienced suddenly not being able to recall a name or simply forgetting an appointment. However, when episodes of impaired memory become more frequent, this can indicate the early signs of dementia. Dementia affects the ability to retain and recall information and is especially noticeable with regard to short-term memory. Patients with advanced dementia are often unable to recall the current year, month, or day. In some cases, they even forget their own name or birthday. Changes in personality, states of confusion, or orientation problems are also common. It can become so severe that those affected are unable to find their way around their own living space.

People with diabetes more frequently have impaired cognitive function and are at greater risk of developing dementia than people with a healthy metabolism. People with diabetes are twice as likely to develop dementia during their lifetime as a person of the same age without diabetes. The good news: There are many ways to reduce the risk of developing dementia – including and especially for people with diabetes.

Specialists assume that there are several causes of the elevated risk of dementia associated with diabetes. These include poor management of blood sugar, blood pressure, and blood lipids, smoking, lack of physical activity, obesity and depression. Based on current knowledge, lack of physical activity is one of the primary drivers of dementia in later life. This also applies to people without diabetes.

Alongside elevated blood sugar levels, severely low blood sugar levels can also promote the onset of dementia. Study data shows that 3 or more cases of severely low blood sugar levels double the risk of later suffering dementia.

Diabetes is associated with a higher risk of eating disorders. Binge eating disorder plays a role particularly in type 2 diabetes. Patients omitting to take their oral antidiabetics is also often reported.

In the case of type 1 diabetes, the intentional skipping of insulin administration to promote weight loss, known as diabulimia, is the primary focus. A further type of eating disorders, one that involves binge eating followed by vomiting or the use of laxatives (bulimia nervosa), has also been observed in adolescent girls with type 1 diabetes.

Risk factors for the onset of eating disorders in patients with diabetes include a younger age, being female, heavier body weight, dissatisfaction with body image, and depression. Many of those affected tend to deny or trivialize their eating disorder.

Eating disorders must be seen as a disease. The consequence of an eating disorder in people for diabetes is poor blood sugar regulation, resulting in a higher risk of complications, such as nephropathy, retinopathy, or cardiovascular diseases. Therefore: The earlier professional help is sought to treat an eating disorder, the better.