Does Recurrent Hypoglycemia Affect Long-Term Cognition?

Intensive insulin therapy did not adversely affect cognition in this follow-up to a landmark diabetes control trial.

In the landmark Diabetes Control and Complications Trial (DCCT), patients with type 1 diabetes (mean age, 27) who received intensive insulin therapy had fewer microvascular complications than conventionally treated patients (Journal Watch Oct 5 1993). After this 6-year randomized trial ended in 1993, intensive treatment was recommended for all participants. Now, after 12 more years of follow-up (during which glycemic control became similar in the 2 groups), 1144 subjects have been reexamined to determine whether an increased incidence of severe hypoglycemia among intensively treated patients affected long-term cognition.

During total follow-up of 18 years, 896 episodes of hypoglycemic coma or seizures occurred in 262 patients in the original…

Reviewing Author

Allan S. Brett, MD