Hypoglycemia is associated with dementia in elderly patients with type 2 diabetes mellitus: An analysis based on the Korea National Diabetes Program Cohort.
OBJECTIVE
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.
Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Republic of Korea.
Sang Ouk
SO
Chin
Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Republic of Korea.
Sang Youl
SY
Rhee
Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Republic of Korea.
Suk
S
Chon
Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea.
Sei Hyun
SH
Baik
Department of Internal Medicine, Hanyang University College of Medicine, Guri, Republic of Korea.
Yongsoo
Y
Park
Department of Internal Medicine, Inha University School of Medicine, Incheon, Republic of Korea.
Moon Suk
MS
Nam
Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea.
Kwan Woo
KW
Lee
Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea.
Ki Hong
KH
Chun
Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Republic of Korea.
Jeong-Taek
JT
Woo
Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Republic of Korea. Electronic address: kimys@khmc.or.kr.
Young Seol
YS
Kim
D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000209:etiology; D015331:Cohort Studies; D003704:Dementia / Q000209:etiology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology*; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D056910:Republic of Korea / Q000453:epidemiology
D007004:Hypoglycemic Agents
Dementia; Hypoglycemia; Type 2 diabetes