Source / information
Source:
Whitmer RA et al. Neurology. 2021; doi: 10.1212 / WNL.000000000000012243.
Disclosure:
The researchers report no relevant financial disclosures.
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Severe hypoglycemic and hyperglycemic events correlated with an increased risk of dementia in older adults with type 1 diabetes, according to a longitudinal study of more than 2,800 patients published in Neurology.
“For people with diabetes, both high and low blood sugar levels are emergencies and both extremes can largely be avoided. If they do, however, they can lead to coma, increased hospital stays, and even death. ” Rachel A. Whitmer, PhD, the department of epidemiology at the Davis School of Medicine at the University of California, it said in a press release. “People with type 1 diabetes are living longer than before, which can put them at risk for conditions like dementia. If we can potentially lower their risk of dementia by controlling their blood sugar levels, it could have positive effects on individuals and public health as a whole. “
Whitmer and colleagues found that severe hypoglycemic and hyperglycemic events correlated with an increased risk of dementia in older adults with type 1 diabetes. Source: Adobe Stock
Whitmer and colleagues investigated a possible association between major hypoglycemic and hyperglycemic events and long-term risk of dementia in older adults with type 1 diabetes.
The longitudinal study included 2,821 patients with type 1 diabetes who were enrolled in an integrated health care system between 1997 and 2015. The mean age of the patients at the start of the study was 56 years; 14% had a history of severe hypoglycemia, 12% had a history of severe hyperglycemia, and 3% had both severe hypoglycemia and hyperglycemia.
Researchers recorded diabetic events that required hospitalization or an emergency room according to patients’ medical records and tracked patients for a diagnosis of dementia through September 2015. Whitmer and colleagues used proportional Cox hazard models that took factors such as age, gender, race / ethnicity, HbA1c. were adjusted to depression, stroke and nephropathy.
Over a mean follow-up period of 6.9 years, the researchers found that 5.4% of the patients developed dementia. In fully adjusted models, subjects with a history of hypoglycemic events had a 66% higher risk of developing dementia than subjects without hypoglycemia (HR = 1.66; 95% CI 1.09–2.53). Patients with hyperglycemic events had a more than twice as high risk of dementia (HR = 2.11; 95% CI 1.24-3.59) compared to patients without. In addition, the researchers observed a six-fold higher risk of dementia in patients with both severe hypoglycemia and hyperglycemia compared to patients with no previous event (HR = 6.2; 95% CI 3.02-12.7).
The researchers also looked at the incidence rates of dementia. Adjusted for age, they observed an incidence rate for dementia of 26.5 cases per 1,000 person-years in people with hypoglycemic events compared to 13.2 cases in people without such events. Whitmer and colleagues reported an incidence rate of dementia of 79.6 cases per 1,000 person-years in people with hyperglycemic events compared to 13.4 cases in people without such events, according to the press release. The incidence rate of dementia in people with hypoglycemic and hyperglycemic events at different times was 98.5 per 1,000 person-years compared to 12.8 per 1,000 person-years for people who had no type of event.
“Our results suggest that exposure to major glycemic events can have long-term effects on brain health and should be seen as an added motivation for people with diabetes to avoid major glycemic events throughout their lives,” Whitmer said in the Message.
Reference:
American Academy of Neurology. High and low blood sugar levels are linked to a higher risk of dementia in type 1 diabetes. Available at: https://www.aan.com/PressRoom/Home/PressRelease/4898. Retrieved June 2, 2021.
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