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Poor glycemic status as a risk factor for dementia in type 2 diabetes population: Findings from the Taiwan's National
Chia-Ling Lin1, Wu-Chien Chien2, Chun-Ping Lin3
1Department of Nursing, Chang Gung University of Science and Technology, Taiwan, ROC.
Aim:
This study explored the association between poor glycemic status (PGS; hyperglycemia, hypoglycemia, or their combination [mixed]) and dementia risk in patients with type 2 diabetes (T2D).
Methods:
In this retrospective cohort study, we conducted a secondary analysis using data from Taiwan's National Health Insurance Database spanning the years 2000 to 2015. We employed propensity score matching (1:1) based on sex, age, index year, and inclusion date to select a comparison cohort, the Cox proportional-hazards regression analysis was performed to assess the effect of PGS on the risk of dementia. Kaplan-Meier survival analysis was performed to compare the cumulative incidence of dementia between patients with T2D and PGS and those without PGS.
Results:
Among 192,977 patients with T2D, 57,893 had PGS during the follow-up period. Of them, 4,342 patients (7.5 %) developed dementia. PGS status was positively associated with dementia risk (adjusted hazard ratio: 2.01; 95 % confidence interval [CI]: 1.58-2.68). The risks of dementia were 1.56 (95 % CI: 1.22-2.08) for hypoglycemia, 1.64 (95 % CI: 1.30-2.18) for hyperglycemia, and 3.10 (95 % CI: 2.48-4.12) for mixed PGS.
Conclusions:
In patients with T2D, PGS is associated with an increased risk of dementia, particularly in those experiencing significant fluctuations in glycemic levels.
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