# Cognitive Training for Diabetes Self-Management

> **NIH NIH R21** · UNIVERSITY OF TEXAS AT AUSTIN · 2022 · $190,853

## Abstract

Abstract
The prevalence of both cognitive dysfunction and diabetes is increasing. Research shows that diabetes
increases the risk for cognitive impairment and the rate of cognitive decline doubles after diabetes is
diagnosed. In turn, cognitive dysfunction can make diabetes self-management more difficult. Diabetes self-
management, essential to good glycemic control, requires both the assimilation of knowledge regarding a
complex disease and self-management activities such as glucose self-monitoring and medication
management. The objective of this R21 application is to pilot test the Memory, Attention, and Problem-Solving
Skills for Persons with Diabetes (MAPSS-DM) intervention, a comprehensive cognitive rehabilitation
intervention, which will include examining patterns of glycemic variability using continuous glucose monitors
(CGMS). The central hypothesis of this proposal is that persons who received the MAPSS-DM intervention will
have improved memory and executive function, greater use of compensatory strategies, and improved self-
management. We will also explore the role of glucose variability in those changes.
The specific aims of this proposal are as follows:
Aim 1. To test the efficacy of the MAPSS-DM intervention for improving cognitive function, A1C, and
diabetes self-management. Sixty-six participants with cognitive concerns and diabetes will be randomly
assigned to either the full MAPSS-DM intervention or an active control. This pilot study will provide estimates of
effect size on the following outcomes: A1C, diabetes self-management, and cognitive function.
 Aim 2. To explore changes in glycemic variability and their association with changes in cognitive
function and diabetes self-management. Participants will use continuous glucose monitors pre-, during, and
post- intervention to identify changes in glycemic variability related to the intervention.
 This project is innovative because it will be the first study to test lifestyle-based online cognitive
rehabilitation as an intervention in T2DM. Providing cognitive rehabilitation that incorporates a widely available
and increasingly acceptable technology (CGMS) is an innovative way to measure the impact of the
intervention. This study will fill an important gap by addressing cognitive function in the management of
diabetes. The results will contribute to the development of the knowledge necessary to enact strategies to
support cognitive function and diabetes self-management which is significant because diabetes is related to
accelerated cognitive aging, cognitive deficits are related to poorer self-management, and improvements in
cognitive performance as a result of cognitive rehabilitation can translate into improved performance in
everyday life and potentially diabetes self-management. Furthermore, the proposed study will offer new
mechanistic insights into cognitive function through use of CGMS.

## Key facts

- **NIH application ID:** 10375550
- **Project number:** 5R21NR019266-02
- **Recipient organization:** UNIVERSITY OF TEXAS AT AUSTIN
- **Principal Investigator:** Heather Cuevas
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $190,853
- **Award type:** 5
- **Project period:** 2021-03-19 → 2024-02-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10375550

## Citation

> US National Institutes of Health, RePORTER application 10375550, Cognitive Training for Diabetes Self-Management (5R21NR019266-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10375550. Licensed CC0.

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