Sang Ouk Chin1, Sang Youl Rhee2, Suk Chon2, Sei Hyun Baik3, Yongsoo Park4, Moon Suk Nam5, Kwan Woo Lee6, Ki Hong Chun7, Jeong-Taek Woo2, Young Seol Kim8. 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.
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 DMpatients aged ⩾60years.
Authors: Sang Youl Rhee; Hyun Jin Kim; Seung Hyun Ko; Kyu Yeon Hur; Nan Hee Kim; Min Kyong Moon; Seok O Park; Byung Wan Lee; Kyung Mook Choi; Jin Hwa Kim Journal: Diabetes Metab J Date: 2017-10 Impact factor: 5.376