Hypoglycemic Events Increase Dementia Risk with Diabetes

Risk increases with the number of hypoglycemic events, nearly doubling for three or more

16 april 2009-- Incidents of hypoglycemia in older patients with type 2 diabetes increase the risk of their eventually developing dementia, according to a study in the April 15 issue of the Journal of the American Medical Association.

Rachel A. Whitmer, Ph.D., of Kaiser Permanente in Oakland, Calif., and colleagues conducted a longitudinal study of 16,667 patients (mean age of 65 years) with type 2 diabetes. Hypoglycemic events that occurred from 1980 to 2002 were identified from hospital and emergency department records, and then followed up until 2007 to determine whether dementia diagnoses developed. From these data, the risk of developing dementia was calculated using Cox proportional hazard regression models.

The investigators found that dementia was eventually diagnosed in 1,822 patients, among whom 250 had had at least one hypoglycemia incident. Compared to patients with no hypoglycemia incidents, the group had an elevated risk of dementia that increased with the number of episodes. The adjusted hazard ratios were 1.26 for one hypoglycemic incident, 1.80 for two incidents, and 1.94 for three or more incidents. The risk of dementia attributable to hypoglycemic incidents was 2.39 percent per year, the researchers report.

"Among older patients with type 2 diabetes, a history of severe hypoglycemic episodes was associated with a greater risk of dementia. Whether minor hypoglycemic episodes increase risk of dementia is unknown," the authors write.

Abstract
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