EASD 2020 — Increased dementia risk in patients with poorly controlled type 2 diabetes


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  • Conference Reports
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Takeaway

  • Type 2 diabetes (T2D) is associated with a higher risk for vascular dementia (VD).
  • Poor glycaemic control (HbA1c >53 mmol/L) in T2D increases risk for VD and non-vascular dementia (NVD).
  • Influence of risk factors for dementia in T2D varies by dementia subtypes.
  • Identification of modifiable lifestyle risk factors in high-risk individuals along with preventative approaches could alleviate dementia risk in patients with T2D.

Why this matters

  • T2D is associated with increased dementia risk, but its relation with dementia subtypes has not been studied extensively.

Study design

  • An observational study (median follow-up, 6.7 years) analysed data of 378,299 patients with T2D (mean age, 64.13 years) and 1,886,022 matched control participants from the Swedish National Diabetes Registry.
  • Outcomes: risk for Alzheimer’s disease (AD), VD and NVD.
  • Funding: Swedish State and others.

Key results

  • 10,143 and 46,479 participants developed dementia in T2D and control cohorts, respectively.
  • Patients with T2D had the highest risk for VD (HR, 1.35), followed by NVD (HR, 1.08), and a lower risk for AD (HR, 0.92).
  • Compared with patients with T2D having optimal HbA1C (
  • Compared with patients with T2D having HbA1C
  • Age, diabetes duration, existing cardiovascular diseases (CVDs), body mass index and blood pressure were key factors mediating dementia risk in T2D.
  • CVD-related factors increased the risk for VD by 40%, NVD by 20% and AD by 10% in patients with T2D.

Limitations

  • No direct cause and effect could be established, owing to the observational nature of the study.
  • Change in lifestyle-related factors was not followed up.