Hypoglycemia Linked with Higher Dementia Risk

A new study published in the April 15 issue of JAMA shows that hypoglycemic episodes that are “severe enough to require hospitalization are associated with a greater risk of dementia for older adults with type 2 diabetes.”

The new findings were presented by Rachel A. Whitmer, PhD, Kaiser Permanente, at a JAMA media briefing at the National Press Club in Washington, DC.

Though many studies have evaluated the association between hypoglycemia and impaired cognitive function in young populations with type 1 diabetes, this study is unique in that it looked specifically at older patients who are usually more likely to have type 2 diabetes.

Dr. Whitmer’s study “included 22 years (1980-2002) of follow-up for hypoglycemic episodes and more than 4 years (starting in 2003) of follow-up for diagnosis of dementia, included 16,667 patients with type 2 diabetes (average age, 65 years). The researchers found that a total of 1,822 patients (11 percent) had a diagnosis of dementia and 1,465 patients (8.8 percent) had at least 1 episode of hypoglycemia; 250 patients had both dementia and at least 1 episode of hypoglycemia (16.95 percent).”

When compared with patients who did not have hypoglycemia, patients with one hypoglycemic episode had a 26% increased risk of developing dementia, and those with two hypoglycemic episodes had an 80% increased risk. "

Our results suggest that hypoglycemic episodes severe enough to require hospitalization or an ED visit are associated with increased risk of dementia, particularly for patients who have a history of multiple episodes," the researchers write.

The authors concluded that "A large body of evidence suggests that individuals with diabetes are at an increased risk of dementia, yet exact mechanisms are not known; our study suggests a potentially modifiable mechanism. Pharmacologically induced severe hypoglycemia may be associated with neurological consequences in an older population already susceptible to dementia. More scientific studies examining hypoglycemia and cognitive performance and brain-imaging sequelae in populations of older patients with type 2 diabetes are needed."