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Diabetes Care. 2019 Mar 4. pii: dc181399. doi: 10.2337/dc18-1399. [Epub ahead of print]

Importance of Treatment Status in Links Between Type 2 Diabetes and Alzheimer Disease.

Author information

1
Department of Psychology, University of Southern California, Los Angeles, CA danation@usc.edu ecmcinto@usc.edu.

Abstract

OBJECTIVE:

To investigate relationships among type 2 diabetes treatment, Alzheimer disease biomarkers, and risk for dementia.

RESEARCH DESIGN AND METHODS:

Participants from the Alzheimer Disease Neuroimaging Initiative (N = 1,289) who were dementia-free at baseline and underwent health assessment, cognitive testing, and MRI. A subset (n = 900) obtained a lumbar puncture to determine cerebrospinal fluid (CSF) phosphorylated tau (p-tau), total tau (t-tau), and β-amyloid 1-42 (Aβ1-42). Participants were grouped by fasting blood glucose and medication history: euglycemia (EU), prediabetes (PD), untreated diabetes (UD), and treated diabetes (TD). Relationships were investigated between treatment status and CSF biomarkers and risk for dementia.

RESULTS:

The UD group displayed greater p-tau, t-tau, and p-tau/Aβ1-42 levels than the EU, PD, and TD groups (P values <0.05) and higher t-tau/Aβ1-42 than the EU and PD groups (P values <0.05). The UD group progressed to dementia at higher rates than the EU group (hazard ratio 1.602 [95% CI 1.057-2.429]; P = 0.026).

CONCLUSIONS:

Treatment status may alter the relationship between type 2 diabetes and both Alzheimer disease biomarker profile and risk for dementia. UD is associated with elevated tau pathology and risk for dementia, whereas TD is not. Although this study is observational and therefore causality cannot be inferred, findings support the potential importance of treatment status in Alzheimer disease risk associated with type 2 diabetes.

PMID:
30833374
DOI:
10.2337/dc18-1399

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