COMMENTARY

High Blood Sugar and Dementia: No Diabetes Needed

Henry R. Black, MD

Disclosures

September 19, 2013

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Hi. I am Dr. Henry Black. I am an adjunct Clinical Professor of Medicine at the New York University Langone Medical Center, and former President of the American Society of Hypertension.

As we age and as we get more obese, 2 things happen: more diabetes and more dementia. We are not exactly sure what leads to dementia. There are many causes -- including, predominantly, aging -- but people with diabetes seem to be at particular risk of developing dementia.

We tend to define diabetes by looking at a blood sugar level or a hemoglobin A1c level. The choice is somewhat arbitrary. We take a continuous variable, namely glucose level, and then categorize people as diabetic or not. We used to use the term "prediabetes"; now we talk about impaired glucose tolerance, but it is a somewhat fuzzy definition.

A recent look for the development of dementia in the Puget Sound-Seattle area database revealed some very interesting findings.[1] This analysis was by a group looking at the Seattle area and people who were enrolled in the Adult Changes in Thought study database in 1994-1996, with more added from 2000 to 2002. They did not explain why they split it that way.

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