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HbA1c variability associated with dementia risk in people with type 2 diabetes

Chris Moran1,2,3,4, Rachel A Whitmer5,6, Zoe Dove6,7

  • 1School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|July 3, 2024
PubMed

Insights

Glycemic control variability, even with optimal HbA1c levels, increases dementia risk in type 2 diabetes patients. Minimizing blood sugar fluctuations is crucial for brain health.

Area of Science:

  • Endocrinology
  • Neurology
  • Public Health

Background:

  • Poor glycemic control is a known risk factor for dementia.
  • The impact of glycemic variability on dementia risk, particularly in individuals with well-managed blood sugar, remains unclear.

Purpose of the Study:

  • To investigate the association between long-term glycosylated hemoglobin A1c (HbA1c) variability and dementia risk.
  • To determine if HbA1c variability increases dementia risk even in individuals with optimal HbA1c levels.

Main Methods:

  • A cohort of 171,964 individuals with type 2 diabetes was analyzed.
  • Five measures of HbA1c variability, including standard deviation (SD), were used to assess dementia risk.
  • Analyses adjusted for demographic factors and comorbidities.

Main Results:

  • Increased HbA1c variability, measured by SD, was significantly associated with a higher hazard of dementia (aHR=1.15).
  • This association was pronounced in individuals with mean HbA1c levels below 8%, including those with optimal levels (<6% or 6-8%).
  • No significant association was found for those with mean HbA1c ≥ 8%.

Conclusions:

  • Greater HbA1c variability poses an increased risk for dementia, irrespective of achieving ideal HbA1c targets.
  • These findings underscore the clinical importance of managing glycemic variability to mitigate dementia risk.
Abstract

Keywords:
dementiadiabetesglycemic controlglycosylated hemoglobin A1c variability

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