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Blood glucose fluctuations associated with dementia in type 2 diabetes
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Variability in blood glucose levels was closely associated with cognitive impairment in older patients with type 2 diabetes, according to researchers in Japan.
“Dementia is often complicated in elderly subjects with diabetes mellitus and is recognized as one of the diabetic complications,” Tomoe Kinoshita, of the department of diabetes, endocrinology and metabolism at Kawasaki Medical School, Kurashiki, Japan, and colleagues wrote. “Indeed it was reported that the incidence of Alzheimer’s disease and vascular dementia was significantly higher in subjects with diabetes compared to those with normal glucose tolerance. Therefore, in order to obtain the quality of life in subjects with diabetes, it would be very important to understand the underlying mechanism for dementia and to explore the way to prevent the development of dementia.”
The researchers recruited 88 patients aged 65 years and older with type 2 diabetes who were admitted to the hospital at Kawasaki Medical School from January 2014 to December 2015. The mean age was 74.92 years, and mean duration of diabetes was 18.31 years. Kinoshita and colleagues used the patients’ glycoalbumin/HbA1c ratio to determine blood glucose fluctuation, and the Hasegawa dementia scale-revised score and mini mental state examination score to evaluate cognitive impairment.
Multivariate analyses indicated that age (P = .001), urinary albumin excretion (P = .007) and glycoalbumin/HbA1c ratio (P = .027) were independent factors for cognitive impairment, while hypoglycemia was not.
Kinoshita and colleagues noted “we still think that hypoglycemia has some bad influence for cognitive impairment.
“Taken all information together, including the data in our present study and those in various important reports, it is likely that there is a close association between the fluctuation of blood glucose levels and cognitive impairment in elderly subjects with diabetes,” the researchers wrote. “In conclusion, since it is very easy to calculate glycoalbumin/HbA1c ratio, a marker of the fluctuation of blood glucose levels, we should check this ratio so that we can reduce the fluctuation of blood glucose levels especially in elder subjects with type 2 diabetes.” – by Andy Polhamus
Disclosure: Kinoshita reports no relevant financial disclosures. Please see the full study for a complete list of all other authors’ relevant financial disclosures.
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