Brain surrounded by sugar cubes and blood pressure gauges symbolizing cognitive clarity and brain health.

Unlocking Cognitive Clarity: How Blood Sugar and Blood Pressure Impact Your Brain

Nico Varela in Health & Wellness November 2025 • 5 min read.

"New research sheds light on the critical role of managing blood sugar and blood pressure for optimal cognitive function, especially in diabetes. Discover practical steps to protect your brain health."

For nearly a century, scientists have observed a connection between diabetes and cognitive function. Today, we understand that type 2 diabetes, the most prevalent form of the disease, and its precursor, prediabetes, can trigger a range of cognitive changes. These changes can vary from subtle cognitive decline to more severe forms of dementia. As the diabetes epidemic continues and life expectancy increases, understanding and addressing these cognitive impacts has become more critical than ever.

While the underlying mechanisms are still being investigated, metabolic and vascular factors are believed to play a significant role. Previous studies have largely focused on whether the effects of type 2 diabetes on cognitive performance are independent of cardiovascular risk factors, confirming the involvement of hyperglycemia, insulin resistance, and vascular issues, especially blood pressure abnormalities.

But what if these factors don't just correlate with cognitive decline, but actually cause it? New research investigates the extent to which differences in cognitive performance among individuals with varying glucose metabolism statuses—normal, prediabetic, and type 2 diabetes—can be attributed to hyperglycemia, insulin resistance, and blood pressure-related variables. Let's explore what they found.

The Key Culprits: Hyperglycemia and Blood Pressure

Brain surrounded by sugar cubes and blood pressure gauges symbolizing cognitive clarity and brain health.

A groundbreaking study, “The Role of Hyperglycemia, Insulin Resistance, and Blood Pressure in Diabetes-Associated Differences in Cognitive Performance—The Maastricht Study,” published in Diabetes Care on August 25, 2017, delved deep into these connections. Researchers analyzed data from 2,531 participants in The Maastricht Study, each of whom completed a comprehensive neuropsychological test battery. This allowed them to assess cognitive functions like memory, processing speed, and executive function.

Hyperglycemia was measured using a composite index incorporating fasting glucose, postload glucose, glycated hemoglobin (HbA1c), and tissue advanced glycation end products (AGEs). Insulin resistance was assessed via the HOMA of insulin resistance index, while blood pressure-related variables included 24-hour ambulatory pressures, their weighted standard deviations, and the use of antihypertensive medication.

The study's results revealed some critical insights:

Individuals with type 2 diabetes performed worse in all cognitive domains compared to those with normal glucose metabolism.
Those with prediabetes did not show significant cognitive decline.
Hyperglycemia largely explained the differences in processing speed and executive function and attention.
Blood pressure-related variables also contributed to differences in processing speed.

It's important to note that insulin resistance did not appear to be a significant factor in explaining cognitive differences in this study, and none of the factors examined explained differences in memory function. This suggests that early control of glycemic levels and blood pressure, perhaps even in the prediabetic stage, could be promising therapeutic targets for preventing diabetes-associated cognitive decline. It's not just about preventing full-blown diabetes; it's about proactively safeguarding your brain health.

Take Charge of Your Cognitive Health

The Maastricht Study's findings offer a compelling reason to prioritize glycemic control and blood pressure management. By proactively addressing these risk factors, you can positively influence your long-term cognitive well-being. While the study sheds light on some critical factors, it also underscores the complexity of the relationship between diabetes and brain health. Further research is needed to fully understand these intricate connections and develop even more targeted interventions. It is important to consult your doctor and dietician if you have any further concerns.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.2337/dc17-0330, Alternate LINK

Title: The Role Of Hyperglycemia, Insulin Resistance, And Blood Pressure In Diabetes-Associated Differences In Cognitive Performance—The Maastricht Study

Subject: Advanced and Specialized Nursing

Journal: Diabetes Care

Publisher: American Diabetes Association

Authors: Stefan L.C. Geijselaers, Simone J.S. Sep, Danny Claessens, Miranda T. Schram, Martin P.J. Van Boxtel, Ronald M.A. Henry, Frans R.J. Verhey, Abraham A. Kroon, Pieter C. Dagnelie, Casper G. Schalkwijk, Carla J.H. Van Der Kallen, Geert Jan Biessels, Coen D.A. Stehouwer

Published: 2017-08-25

Everything You Need To Know

According to The Maastricht Study, how did cognitive performance differ between individuals with type 2 diabetes, prediabetes, and normal glucose metabolism?

The Maastricht Study found that individuals with type 2 diabetes exhibited poorer performance across all assessed cognitive domains when compared to individuals with normal glucose metabolism. However, those with prediabetes did not demonstrate significant cognitive decline. The study also revealed that hyperglycemia significantly accounted for differences in processing speed, executive function, and attention, while blood pressure-related variables contributed to variations in processing speed. Interestingly, insulin resistance did not emerge as a significant factor in explaining cognitive differences, and none of the examined factors accounted for differences in memory function.

How were hyperglycemia, insulin resistance, and blood pressure-related variables specifically measured and assessed within The Maastricht Study?

In The Maastricht Study, hyperglycemia was measured using a comprehensive composite index incorporating fasting glucose, postload glucose, glycated hemoglobin (HbA1c), and tissue advanced glycation end products (AGEs). Insulin resistance was assessed through the HOMA of insulin resistance index. Blood pressure-related variables were evaluated using 24-hour ambulatory pressures, their weighted standard deviations, and the utilization of antihypertensive medication. These detailed measurements allowed researchers to correlate these metabolic factors with cognitive performance.

The Maastricht Study indicated that hyperglycemia and blood pressure affect certain cognitive functions but not others. Which cognitive domain remained unexplained by these factors, and what does this suggest?

The Maastricht Study highlighted that while hyperglycemia and blood pressure significantly influence processing speed, executive function, and attention, these factors did not account for differences in memory function. This suggests that other mechanisms, not fully captured by these variables, might play a crucial role in memory-related cognitive decline in individuals with diabetes or related conditions. Further research is needed to explore these additional factors that impact memory.

If insulin resistance wasn't identified as a significant factor in explaining cognitive differences in The Maastricht Study, does this mean it's not relevant to cognitive decline?

While The Maastricht Study didn't identify insulin resistance as a significant factor in explaining cognitive differences, it doesn't negate the potential long-term impact of insulin resistance on cognitive health. Insulin resistance can contribute to various metabolic disturbances and vascular complications, which, over time, may indirectly affect cognitive function. Future research may explore the indirect pathways through which insulin resistance influences cognitive health, potentially involving chronic inflammation or other metabolic intermediaries.

Based on the findings of The Maastricht Study, what are the potential implications for preventing cognitive decline in individuals at risk of or with diabetes, and what further steps might be necessary?

The implications of The Maastricht Study suggest that proactively managing blood sugar and blood pressure could be promising therapeutic targets for preventing diabetes-associated cognitive decline. Early intervention, even in the prediabetic stage, might help preserve cognitive functions like processing speed, executive function, and attention. However, since memory function wasn't explained by the factors examined, a more holistic approach, including lifestyle modifications, cognitive training, and management of other vascular risk factors, may be necessary to comprehensively safeguard brain health.