1. Improving cognitive function to improve diabetes self-management
February 27,2019
Improving cognitive function to improve diabetes self-management
Heather Cuevas, PhD, RN, ACNS-BC
Assistant Clinical Professor
Research reported here was supported by the National Institute of Nursing Research of the National Institutes of Health under Award Number P30NR The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

2. Background 415 million adults with DM worldwide
T2DM associated with greater decline in cognitive function
Memory and executive function most commonly affected.
What about self-management?
This study addressed:
Perceived cognitive function
Built on prior work
Examines cognitive training as a means to improve self-management
415 million adults with diabetes mellitus worldwide.
Projected to reach over 640 million by 2040.
T2DM in midlife is associated with a greater decline in cognitive function over 20 years than for those without T2DM.
MAPSS-MS: significant effects on use of memory strategies, performance on memory tests.
Cain Center Grant: tested recruitment strategies, establish infrastructure. Examined association of perceived cognitive function with diabetes self-management.
MAPSS-MS has already been adapted for “chemo brain,” Parkinson’s.
Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE)
This intervention model is consistent with the principles of cognitive rehabilitation articulated by the National Academy of Neuropsychology28 that change in function is best accomplished by teaching both compensatory skills (class) and brain retraining (computer practice).

3. Design & Population Interviews Pilot testing of adapted intervention
4 classes
Computer exercises
A1C and self-report measures
Mean age: 55.1 years (10.9)
Mean A1C: 8.3% (1.5)
Mean time with DM: 7.1 years (4.3)
10 Hispanic
3 African American
6 non-Hispanic white
57% female
Interviews: Diabetes self-management, Diabetes’ effect on cognitive function, Cognitive function’s effect on self-management, Class logistics

4. Outcomes Use of cognitive strategies increased
Positive effect on diabetes self-management
Noted glucose variability
Executive function positively correlated with DMSM items
Post intervention scores improved in all areas

5. Limitations & Strengths
Small sample
Self-reported data
Lack of a comparison group
>50% under-represented minority
One of the first to test comprehensive cognitive training in DM

6. Next Steps Add CGMS Test A1C at multiple points Add neuropsych tests
Control group
Glucose variability and cognitive function?
Does long-term DM control change?
Objective measures of cognitive function
Games only vs. Comprehensive intervention

7. THANK YOU