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ICA: Poor Glycemic Control Increases Diabetics' Risk of Dementia

Ed Susman
Reviewed by Zalman S. Agus, MD; Emeritus Professor at the University of Pennsylvania School of Medicine. | July 17, 2006
MADRID -- Uncontrolled hyperinsulinemia for type 2 diabetics significantly boosts their risk of developing dementia, according to a study of more than 22,000 patients in California.

MedPage Today Action Points
    • Explain to interested patients that this study associated poor glycemic control with the eventual development of dementia. Point out however that the study cannot prove causality.

    • Explain that aside from medication lifestyle changes, especially exercise, can help control blood sugar levels.

    • This study was published as an abstract and presented orally at a conference. These data and conclusions should be considered to be preliminary as they have not yet been reviewed and published in a peer-reviewed publication.

MADRID, July 17 -- Diabetic patients with glycosylated hemoglobin (HbA1c) levels that are well out of control are driving down the road towards dementia, researchers said here Sunday.

Type 2 diabetes patients with HbA1c levels in excess of 15 have a 78% greater risk of developing dementia or Alzheimer's disease or cognitive decline in the next decade, said Rachel Whitmer, Ph.D., an investigator at Kaiser Permanente Northern California in Oakland.

Those with very poor glycemic control -- HbA1c levels greater than 10 -- were at an increased risk of incident dementia, she said in a report at the International Conference on Alzheimer's Disease and Related Disorders here. "Strict glycemic control is important for patients with diabetes in old age."

She said that compared with the 19,318 patients who had a HbA1c less than 10, those 1,286 patients with levels between 10 and 11.9 were 16% more likely to have dementia (HR=1.16, 95% CI 1.01-1.32).

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