High and Low Blood Sugars: How Do They Affect Cognitive Performance?

I repeat: there were no differences in task accuracy. However, the time it took to complete the task was longer (seconds, not minutes or hours). The information that both hypo and hyperglycemia may cause difficulties is especially significant. This reinforces the need to decrease blood glucose variability and to blunt those peaks and valleys that are noted on blood glucose downloads. Of course, this is easier to recommend than actually execute. However, simple changes may help to decrease blood glucose variability.

1. Try to bolus before meals and snacks as much as possible (even 15 minutes before to match the carbohydrate excursion).
2. Carbohydrate count as carefully as possible.
3. Check blood glucose levels frequently; especially 2-3 hours after eating. Studies have demonstrated, that post-prandial blood sugars play a major role in those children, teens, and adults that have lower hb A1c.
4. Pay attention to the physical signs of lows or highs as you may be feeling the rapid drop or increase of glucose levels rather than the actual blood glucose in mg/dl.
5. Pay close attention to the need to change insulin/carbohydrate ratios or insulin sensitivity factors during times of rapid growth, stress, illness, exercise, etc.
6. Monitor blood sugars overnight periodically to observe for the dawn phenomenon or post-exercise induced hypoglycemia.
7. Consider use of a continuous glucose sensor for diagnostic purposes or if you are extremely motivated to monitor trends in glucose levels. A compromise would be to wear a sensor for a week (every month or so...for example) when major fluctuations are noted so that changes in insulin dosing may be made. This is of particular importance in children that are undergoing rapid growth spurts or going through puberty.
8. Download meters at home and observe the peaks and valleys. Contact your diabetes team for advice.
9. Consider a change in your current insulin regime if your blood sugars are all over the place.
10. Bolus before eating carbs ... always.

Keep in mind that these are the results of one field study. More research needs to be conducted to verify and enhance these findings. However, based on this information, much of what we know by fact and feel has been verified and we should act accordingly.

We can now use this study as a reference for testing accommodations to provide extra time for our students (But we knew that already per the Americans with Disability Act.)

I will continue to keep watch for further studies.