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Monday 21st May 2018

Dementia risk for diabetes patients

21st April 2009

As people with type 2 diabetes age, they may be at risk of developing dementia if their blood sugar levels are too low.

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However, researchers are uncertain whether or not commonly severe episodes of low blood sugar as commonly experienced present a similar threat.

Rachel Whitmer of Kaiser Permanente, who authored the study, said that hypoglycaemic episodes that were severe enough to require hospitalisation or emergency-room visits were associated with a greater risk of dementia.

She said that this proved especially true for patients who had multiple episodes, independent of glycaemic control.

Although the reasons are not clear, people with type 2 diabetes have a 32% increased risk of dementia.

Whitmer said that episodes of hypoglycaemia might be associated with neurological consequences in patients already at risk for dementia, and that the study seemed to suggest that hypoglycaemia was one of the reasons for that risk.

Nir Barzilai, director of the Institute for Aging Research at Albert Einstein College of Medicine and the Montefiore Hospital Diabetes Clinic in New York City, said that the study did not establish a causal relationship between dementia and type 2 diabetes.

He said that the increased risk could be due to the fluctuation of glucose instead, and that hyperglycaemia was also a toxic condition.

Whitmer said that the finding also added to the evidence base that balance of glycaemic control was a critical issue, especially for people as they age, and noted that hypoglycaemia was probably just one reason for the risk in individuals who test positive for type 2 diabetes.

For a period of almost 30 years, the study authors gathered data on nearly 17,000 patients with a diagnosis of type 2 diabetes.

For most of that time, they paid attention to the patients' hypoglycaemic episodes, and spent four years following them recording episodes of dementia.

While the accelerated death of nerve cells in the brain could be a possible mechanism for the occurrence of dementia in these cases, a decreased flow of blood to the brain could be as well.

But Barzilai said that the glucose concentrations in the brain were much, much lower than in the body.

He said that the brain did not in fact subsist on glucose but on other metabolites.

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