Sunday, June 15, 2025

Dementia in Diabetes

 Hypoglycemia, a common consequence of diabetes treatment, is associated with severe morbidity and mortality

 and has become a major barrier to intensifying antidiabetic therapy

 Mild hypoglycemia can cause troubling symptoms such as anxiety, palpitations, and confusion. 

Dementia generally refers to the loss of memory, language, problem-solving, and other 

cognitive functions, which can interfere with daily life, 

and there is growing evidence that diabetes

 is associated with an increased risk of both vascular and non-vascular dementia.

 Neuroglycopenia resulting from a hypoglycemic episode in diabetic patients can lead to the

 degeneration of brain cells, 

with a resultant cognitive decline, leading to dementia.

 In light of new evidence, a deeper understating of the relationship between hypoglycemia and dementia

 can help to inform and guide preventative strategies. 


AHypoglycemia is a known adverse effect

 of glucose-lowering therapies. Hypoglycemia is defined as plasma glucose levels below 70 mg/dL, as per the American Diabetes Association guidelines [1]

Multiple diabetic drugs can induce hypoglycemia, predominantly including, but not limited to, insulin in type 1 diabetes (T1D) and type 2 diabetes (T2D), and sulfonylureas (in T2D); there have also been associations with biguanides and thiazolidinediones [4]. With the onset of hypoglycemia,.



The prevalence of hypoglycemic episodes ranges from 10% in T2D to 50% in T1D; however, despite the overall prevalence, the relationship between hypoglycemia and dementia 

typically refers to the elderly population as, over time, there is a reduced awareness of hypoglycemic symptoms, in addition to reduced counter-regulatory glucagon secretion [7,8]. Combined, these effects amplify the hypoglycemic risk of glucose-lowering therapies in elderly patients [9,10


There is increasing evidence that hypoglycemic episodes in patients with diabetes are a risk factor for dementia




Ref

. 2023 Jun 7;24(12):9846. doi: 10.3390/ijms24129846

Dementia in Diabetes: The Role of Hypoglycemia

Editor: Masashi Tanaka

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