In terms of the confusion issue, it depends on what you read. Two things may have popped up
Theories that in the long term hypos cause cogntive impairments due to chronic starvation of glucose to the brain. No proof either way I suppose.Serious hypos can cause brain damage but thats serious,unconscious paramedic hypo stuff.
Theories that Alzheimers is more likely in diabetics due to the microvascular (small vessels) damage cause by sugar sticking to the haemoglobin/vessels). Conversely I read that insulin helps protect agains Alzheimers so...........
As for the A1c, thats a great indicator of how much damage you could get so as low as possible/normal to non diabetics as possible is great. Wifes is great. I would say however there are suggestions that high spikes cause some damage and a good score doesnt tell you about the day to day routine. I know someone with an A1c of 5 who has hypos every day in the 2's, and can jump to the 20's
Still, all we can do is our best and then hope the rest is ok :?