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Diabetes Res Clin Pract. 2016 Dec;122:54-61. doi: 10.1016/j.diabres.2016.09.027. Epub 2016 Oct 8.

Hypoglycemia is associated with dementia in elderly patients with type 2 diabetes mellitus: An analysis based on the Korea National Diabetes Program Cohort.

Author information

1
Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Republic of Korea.
2
Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Republic of Korea.
3
Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea.
4
Department of Internal Medicine, Hanyang University College of Medicine, Guri, Republic of Korea.
5
Department of Internal Medicine, Inha University School of Medicine, Incheon, Republic of Korea.
6
Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea.
7
Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea.
8
Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Republic of Korea. Electronic address: kimys@khmc.or.kr.

Abstract

AIM:

Although hypoglycemia is associated with cognitive dysfunction, including dementia, in patients with type 2 diabetes mellitus (DM), the data are equivocal. The purpose of this study was to investigate the association between hypoglycemia, dementia, and other cognitive dysfunctions.

METHODS:

This was a prospective observational study based upon the Korea National Diabetes Program (KNDP). Among the 4540 participants in the KNDP cohort, individuals aged ⩾60years without any history of hypoglycemia or cognitive dysfunction (n=1957) were included. Nationally representative data from the Health Insurance Review and Assessment Service of Korea claim database were used to obtain a more precise determination of patient outcome.

RESULTS:

During a mean follow-up period of 3.4±0.9years, 118 subjects experienced hypoglycemia-related events. The incidence of dementia and cognitive dysfunction was 7.5 cases per 1000 person-years (PY) and 0.61 cases per 1000 PY, respectively. In the subjects who experienced hypoglycemic events (relative to those who did not), the incidence of dementia was significantly higher (P=0.0139), but the incidence of cognitive dysfunction was not (P=0.1106). Hypoglycemic events were associated with dementia (HR, 2.689; 95% CI, 1.080-6.694, P=0.0335) following multiple adjustments. There was also a significant linear trend toward an increased dementia risk commensurate with an increasing number of hypoglycemic events (P=0.0286).

CONCLUSIONS:

Hypoglycemia is significantly associated with the risk of dementia in Korean type 2 DM patients aged ⩾60years.

KEYWORDS:

Dementia; Hypoglycemia; Type 2 diabetes

PMID:
27810686
DOI:
10.1016/j.diabres.2016.09.027
[Indexed for MEDLINE]

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