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Cognitive disoders are common for the patients with diabetes mellitus type 2, caused by cerebrovascular changes related to micro- and macroangiopathy, metabolic disturbances and hypoglycaemic episodes as of cognitive impairment in turn impedes the adaptation of the patient, has negative influence on their compliance, increasing the risk of hypoglycaemia due to an overdose of glucose lowering medications or improper diet. Moreover, associated with cognitive impairment inability to recognize hypoglycaemia in time and promptly provide first aid is threatening of severe hypoglycaemia events with serious consequences including hospitalisation and mortality. Therefore, identification of the causes and underlying mechanisms, clinical peculiarities and consequences of hypoglycemia in patients with DM type 2 and cognitive impairment is of high importance regarding the development of early diagnosis methods, treatment algorithms and effective prevention.