treat patients with diabetes, not their numbers (esp the elderly!!)
Studies have shown that older patients with diabetes and hypertension (and hyperlipidemia, to a lesser degree) have increased likelihood of cognitive impairment as well as brain atrophy (also a predictor of subsequent cognitive decline). As part of the ACCORD trial (RCT of 10K diabetic pts with prevalent CAD or lots of risk factors, treated with intensive vs less-intensive glucose control, as well as greater or lesser lipid and blood pressure control), the Memory in Diabetes (MIND) substudy also assessed cognitive and MRI outcome of total brain volume (TBV) (see htn tight control DM inc cognitive decline jama int med 2014 in dropbox, or doi:10.1001/jamainternmed.2013.13656). Cognitive assessment was for psychomotor function and speed of learning/working memory ( Digit Symbol Substitution Test) , verbal memory and executive function (Rey Auditory Verbal Learning Test and Stroop Color-Word Test) and Mini-Mental Status Exam. 2977 participants without baseline cognit...