Dementia and Hypoglycemic Episodes in Patients With Type 2 Diabetes Mellitus
- Alex J. Graveling, MBChB, MRCP;
- Brian M. Frier, BSc, MD, FRCP brian.frier@luht.scot.nhs.ukDepartment of DiabetesRoyal Infirmary of EdinburghEdinburgh, United Kingdom
Since this article does not have an abstract, we have provided the first 150 words of the full text.
- KEYWORDS:
- AGING
- DATA INTERPRETATION, STATISTICAL
- DEMENTIA
- DIABETES MELLITUS, TYPE 2
- HYPOGLYCEMIA
- NEUROGLYCOPENIA
- RISK FACTORS
To the Editor: Dr Whitmer and colleagues1 reported a relationship between severe hypoglycemia and incident dementia in a large cohort of older people with type 2 diabetes. Although severe hypoglycemia may cause permanent cognitive impairment, the results of this study should be viewed with caution. It seems unlikely that a single episode of severe neuroglycopenia could increase the risk of dementia by 50%.
Premorbid cognitive ability was assessed solely by educational attainment. Intellectually able people with diabetes may compensate for declining cognition and be less susceptible to the development of hypoglycemia. Vascular dementia is more common in people with lower cognitive ability2 and may confound a putative association with hypoglycemia. Cerebrovascular disease may both cause dementia and enhance the risk of hypoglycemia. Although the results were adjusted for the most overt diagnoses of stroke, which have a prevalence in the general population of 2% to 3%,3 no …
