COMMENTARY

Blood Glucose and Dementia Risk: The Latest Evidence

Sandra Adamson Fryhofer, MD

Disclosures

November 15, 2013

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Hello. I'm Dr. Sandra Fryhofer. Welcome to Medicine Matters. The topic: blood sugar levels and risk for dementia. Here's why it matters.

Dementia is a major concern for all of us. It's one of our worst fears. Diabetes is an established risk factor for dementia. But a new study published in the New England Journal of Medicine suggests that the influence of sugar levels on dementia begins even sooner.[1]

The study included more than 2000 patients, about 800 men and 1200 women, with a mean age of 76 years at the start. None had dementia but about 200 of them had diabetes. The rest did not. They were followed for 7 years. Blood sugars and hemoglobin A1c levels were closely monitored.

By the end of the study, 524 people had developed dementia, 74 of whom were diabetic. The remainder of those diagnosed with dementia were not.

The study found that patients with higher average blood sugar levels were more likely to develop dementia. For diabetics, risk for dementia was 40% higher in those with sugars averaging around 190, as compared to those with sugars hovering around 160.

Dementia risk was also increased in those with sugars in the prediabetic range. Patients with average sugars of 115 were nearly 20% more likely to develop dementia as compared to those with normal sugar levels of 100.

The researchers say that the underlying mechanisms need further clarification. Insulin resistance and microvascular disease of the central nervous system probably have a role. However, it could be that patients with dementia don't care for themselves as well and thus don't eat properly, which could account for the higher blood sugars.

This study suggests that any increase in glucose above normal increases the risk for dementia. For those with diabetes already, the risk for dementia is even more magnified.

Preventing dementia -- another reason to eat healthy, keep weight under control, and keep blood sugars in the normal range.

For Medicine Matters, I'm Dr. Sandra Fryhofer.

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