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Hypoglycemic events linked to dementia in diabetes

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Study results suggest a bidirectional association between hypoglycemic events and dementia among older adults with diabetes.

Kristine Yaffe, MD, of the department of psychiatry at the University of California in San Francisco, and colleagues from the Health, Aging, and Body Composition (Health ABC) Study team prospectively analyzed the association between hypoglycemia and dementia in 783 adults (mean age, 74 years; 47% black) with diabetes from the Health ABC cohort.

According to 12-year follow-up data, 61 patients (7.8%) reported a hypoglycemic event and 148 (18.9%) developed dementia. Further, those who reported a hypoglycemic event demonstrated a twofold increased risk for developing dementia compared with patients who did not have a hypoglycemic event (HR=2.1; 95% CI, 1-4.4), according to data.

Moreover, patients who developed dementia displayed risks for hypoglycemic events compared with those who did not develop dementia (HR=3.1; 95% CI, 1.5-6.6). The researchers wrote that these findings suggest a bidirectional link between severe hypoglycemia and dementia among older patients.

In an accompanying commentary, Kasia J. Lipska, MD, MHS, of Yale University School of Medicine, and Victor M. Montori, MD, of the Mayo Clinic in Rochester, Minn., wrote that hypoglycemia throughout the course of treatment for type 2 diabetes is common and linked to poor outcomes.

“Therefore, decisions about the intensity and type of antihyperglycemic therapy must take into account the harms of hypoglycemia. Involving patients in these treatment decisions may favorably shift the current glucose-centric paradigm to a more holistic patient-centered one,” they wrote.

For more information:

Lipska KJ. JAMA Intern Med. 2013;doi:10.1001/jamainternmed.2013.6189.

Yaffe K. JAMA Intern Med. 2013;doi:10.1001/jamainternmed.2013.6176.

Disclosure: Yaffe reports serving on data safety monitoring boards for Medivation, Pfizer and Takeda, and consultancy for Novartis. All other researchers report no relevant financial disclosures.