Background: Type 2 diabetes mellitus (T2DM) is associated with an increased risk for dementia. The effects of hypoglycemia on dementia are controversial. Thus, we evaluated whether hypoglycemia increases the risk for dementia in senior patients with T2DM.
Methods: We used the Korean National Health Insurance Service Senior cohort, which includes >10% of the entire senior population of South Korea. In total, 7,752 patients who had ever experienced hypoglycemia were matched with those who had not, using propensity score matching. Forty-eight confounding variables, including age, socioeconomic status, medication use, and underlying diseases, which may affect dementia, were corrected for propensity score matching. The risk of dementia was assessed through a survival analysis of matched pairs.
Results: Patients with underlying hypoglycemic events had an increased risk for all-cause dementia, Alzheimers dementia (AD), and vascular dementia (VaD) compared with those who had not experienced a hypoglycemic event (hazard ratio [HR] 1.254, 95% confidence interval [CI] 1.1661.349, P<0.001 for all-cause dementia; HR 1.264, 95% CI 1.1621.375, P<0.001 for AD; HR 1.286, 95% CI 1.1101.490, P<0.001 for VaD). In the subgroup analysis, hypoglycemia was associated with an increased risk for dementia in both sexes with or without T2DM microvascular or macrovascular complications.
Conclusions: Our findings suggest that patients with a history of hypoglycemia have a higher risk for dementia. This trend was similar for AD and VaD, the two most important subtypes of dementia.
18 - 21 May 2019
European Society of Endocrinology