Diabetic cognitive impairment belongs to the category of “mental deterioration due to consumptive thirst” in traditional Chinese medicine(TCM).Its pathogenesis is deficiency in root causes and excess in manifestations，with organ deficiency as the root and phlegm，stasis，and sugar toxin obstructing collaterals as the manifestation.Sweat pore and collateral vessels are microstructures universally present in the human body，with the function of maintaining the circulation of qi，blood，and body fluids throughout the body.Occlusion of sweat pore and blockage of collateral vessels serve as the pathological basis for the occurrence of various diseases.From the new perspective of “sweat pore-collateral vessels”，this study analyzed its correlation with the onset of diabetic cognitive impairment.The vital activity dysfunction resulting from occlusion of sweat pore and the blockage of collateral vessels in the brain is the pathogenesis of diabetic cognitive impairment.Treatment should focus on dredging.Clinically，formulas based on wind-related drugs derived from insects are adopted to open sweat pore and dredge collaterals，which can enhance the efficacy of treatment，providing insights into the clinical treatment of diabetic cognitive impairment.