Abstract
INTRODUCTION
Although poor glycemic control is associated with dementia, it is unknown if variability in glycemic control, even in those with optimal glycosylated hemoglobin A1c (HbA1c) levels, increases dementia risk.
METHODS
Among 171,964 people with type 2 diabetes, we evaluated the hazard of dementia association with long-term HbA1c variability using five operationalizations, including standard deviation (SD), adjusting for demographics and comorbidities.
RESULTS
The mean baseline age was 61 years (48% women). Greater HbA1c SD was associated with greater dementia hazard (adjusted hazard ratio = 1.15 [95% confidence interval: 1.12, 1.17]). In stratified analyses, higher HbA1c SD quintiles were associated with greater dementia hazard among those with a mean HbA1c < 6% (P = 0.0004) or 6% to 8% (P < 0.0001) but not among those with mean HbA1c ≥ 8% (P = 0.42).
DISCUSSION
Greater HbA1c variability is associated with greater dementia risk, even among those with HbA1c concentrations at ideal clinical targets. These findings add to the importance and clinical impact of recommendations to minimize glycemic variability.
Highlights
We observed a cohort of 171,964 people with type 2 diabetes (mean age 61 years).
This cohort was based in Northern California between 1996 and 2018.
We examined the association between glycosylated hemoglobin A1c (HbA1c) variability and dementia risk.
Greater HbA1c variability was associated with greater dementia hazard.
This was most evident among those with normal–low mean HbA1c concentrations.
If you do not see content above, kindly GO TO SOURCE.
Not all publishers encode content in a way that enables republishing at Neuro.vip.
This post is Copyright: Chris Moran,
Rachel A. Whitmer,
Zoe Dove,
Mary E. Lacy,
Yenee Soh,
Ai‐Lin Tsai,
Charles P. Quesenberry,
Andrew J. Karter,
Alyce S. Adams,
Paola Gilsanz | July 4, 2024