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Hyperglycemia hospitalization exacerbates mortality risk in adults with diabetes, dementia
Adults diagnosed with dementia who also have type 2 diabetes are at increased risk for hospitalization due to severe hyperglycemia and shorter life span, according to findings published in the Journal of Diabetes and its Complications.
“Diabetes self-management, including nutritional management, adequate physical activity and regular monitoring blood glucose, is essential to the prevention and delay in [diabetes] complications,” Ming-Yen Lin, PhD, assistant research fellow of the division of nephrology in the department of internal medicine at Kaohsiung Medical University in Taiwan, and colleagues wrote. “Although there are continuous improvements in the proportion of those meeting recommended glycemic control goals and reductions of hospital admissions due to poorly controlled glucose levels in [the] general [diabetes] population, there are important concerns regarding the capacity of dementia patients, and there remains a need to assess care outcomes [in] this vulnerable [diabetes] population.”
Using the National Health Insurance Research Database of Taiwan, Lin and colleagues conducted a retrospective, observational study using data from 5,314 adults with type 2 diabetes and a recent dementia diagnosis (ICD-9-CM code 290.XX) from 1997 to 2008. Researchers divided patients into groups based on those whose records indicated hospitalization for a hyperglycemic event (n = 303; 214 women; mean age, 75.2 years) and those whose did not (controls; n = 5,011; 3,220 women; mean age, 74.5 years).
At least one hyperglycemic event that required hospitalization was reported by 303 patients, and 45.2% of this group died during the study period vs. 38.2% of the group without a hospitalization for hyperglycemia. The hyperglycemia group had a higher 8-year mortality risk (52.9%) compared with the control group (47.2%; P = .02). When accounting for adjustments, the researchers found a 30% higher mortality risk in the group with hyperglycemia hospitalizations vs. those without (adjusted HR = 1.3; 95% CI, 1.09-1.55).
In addition, higher risks for hospitalization due to hyperglycemia were observed for women (HR = 0.8; 95% CI, 0.73-0.88), adults with renal disease (HR = 1.7; 95% CI, 1.41-2.05) and those prescribed insulin (HR = 1.24; 95% CI, 1.12-1.38).
“[Diabetes] is prevalent in people with dementia, and more attention is needed to prevent life-threatening [diabetes]-related episodes in this population,” the researchers wrote. “Thus, physicians may want to keep this knowledge in mind when treating [diabetes] in these patients.” – by Phil Neuffer
Disclosures: This study was funded by the Research Center for Environmental Medicine, Kaohsiung Medical University, Taiwan. The authors report no relevant financial disclosures.