The Impact of Blood Sugar Levels & DKA on Your Brain


Coverage of the ADA Scientific Sessions is brought to you by the ADA x BT1 Collab.

People with type 1 and type 2 diabetes face an increased risk of dementia and general cognitive decline, explained several experts at this year’s American Diabetes Association Scientific Sessions.

Trying to determine what aspects of having diabetes impact the wellbeing of your cognitive function the most was an important aspect of their research.

Here, we’ll look at their findings on:

  • risk of dementia in people with diabetes
  • impact of high and low blood sugars on your brain
  • impact of diabetic ketoacidosis (DKA) on your brain

Prevalence of dementia climbs with prevalence of diabetes

The number of cases of both dementia and type 2 diabetes (T2D) are expected to at least double, and potentially triple, over the course of the next 30 years, explained Anna Marseglia, Ph.D.

Diabetes is associated with subtle cognitive decline in all age groups, and is a clearly established risk factor for the development of dementia.

While reducing your risk of dementia as a person with T2D can be managed largely by improving your overall blood sugar levels, Marseglia’s research suggests another major factor: an active life.

The phrase “active life” includes physical activity, mental activity and social activity according to the study, “Participating in Mental, Social and Physical Leisure Activities and Having a Rich Social Network Reduce the Incidence of Diabetes-Related Dementia.”

In people with diabetes who had lower levels of overall activity and a poor social network their risk of developing dementia was significantly higher than those with moderate-to-high levels of leisure activity and/or a rich social network.

Blood Sugar Levels & Brain Injury

Many would assume that low blood sugar levels cause more damage and injury to your brain than high blood sugars, after all, when we’re low, it can be difficult to think straight, to speak clearly, to stay on your feet.

Research on people of all ages with T1D proved otherwise, explained presenter Fergus Cameron, M.D.

Editor’s Note: DKA is now considered more common in children and adults with T2D at the time of diagnosis, making this data pertinent to both types of diabetes

“The circumstances that occur shortly before or after the time of diagnosis can create predispositions for neural injury,” added Cameron who broke down the findings of several studies, including:

In a nutshell: the various studies have all found that the weeks or months of high blood sugar levels and worsening DKA prior to your diabetes diagnosis, and in the days or weeks immediately after, take the greatest toll on a person’s brain, creating the most injury.

Key findings of recent research on the impact of blood sugar levels and the developing brain:

  • Areas of cognitive impairment studied included: full scale IQ, executive function, information processing speed, working memory and general memory.
  • Whether or not a child or adult was in DKA at the time of diagnosis plays a huge role in overall brain injury from T1D.
  • Children diagnosed before age 5, presenting with DKA at diagnosis, showed the highest evidence of brain injury.
  • Children diagnosed after age 10, without DKA at diagnosis, showed the lowest evidence of brain injury.
  • Children with A1c levels over 8 percent performed more poorly compared to IQ norms of same-aged non-diabetic peers.
  • Severe hypoglycemia experienced in early childhood is associated with poorer cognitive performance.
  • Adults who were diagnosed with T1D during childhood have substantially increased evidence of cognitive impairment.
  • Chronically high blood sugar levels cause more injury to the brain than previously thought, and are associated with chronic inflammation and oxidative brain damage.
  • Mild-to-moderate low blood sugars do not damage the brain as significantly as once thought.
  • The evidence of brain injury resulting from DKA, A1c levels over 8 percent, and severe hypoglycemic events are strongest in those who were diagnosed earliest in life.

The findings regarding the potential damage caused by DKA at diagnosis highlight the value of evolving drugs like teplizumab and the JDRF’s T1Detect at-home autoantibody test kit, enabling you to detect type 1 diabetes (T1D) in children long before blood sugar levels are higher than normal, preventing DKA altogether.

For more coverage of the American Diabetes Association’s 81st Scientific sessions, CLICK HERE.

WRITTEN BY Ginger Vieira, POSTED 06/29/21, UPDATED 12/04/22

Ginger Vieira is an author and writer living with type 1 diabetes, celiac disease, fibromyalgia and hypothyroidism. She’s authored a variety of books, including “When I Go Low” (for kids), “Pregnancy with Type 1 Diabetes,” and “Dealing with Diabetes Burnout.” Before joining Beyond Type 1 as digital content manager, Ginger wrote for Diabetes Mine, Healthline, T1D Exchange, Diabetes Strong and more! In her free time, she is jumping rope, scootering with her daughters, or walking with her handsome fella and their dog.