12-year follow-up study: How harmful is poor blood glucose control?

▎Type 2 diabetes and dementia are the main public health challenges facing WuXi AppTec's content team
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Globally, 463 million adults suffer from diabetes and 50 million suffer from dementia
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Researchers estimate that 20% of people ≥65 years of age may be affected by cognitive impairment, and about 1/3 of these people will develop dementia within 5 years
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During the development of the disease, diabetes is a recognized risk factor for dementia
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Will controlling blood sugar slow down the development of dementia? What is the role of cardiovascular disease and increased systemic inflammation in these associations? A recent study published in the journal "Alzheimer's & Dementia" found that diabetes, which is characterized by poor blood sugar control or cardiovascular complications, is associated with an increased risk of developing cognitive impairment; Inflammation may play an important role in the process
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Screenshot source: Alzheimer's & Dementia research team from Karolinska Institutet, Sweden.
The researchers included 2,522 people over 60 years old.
At the beginning of the study, 1,840 people had no cognitive impairment and 682 had Cognitive impairment (preclinical dementia) but not diagnosed as dementia
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The researchers also measured the participants' blood glucose-related indicators glycosylated hemoglobin (HbA1C) and inflammation indicators C-reactive protein levels
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At the beginning of the study, 8.
6% of the participants had type 2 diabetes, and approximately 1/3 of the participants had prediabetes
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After 12 years of follow-up, it was found that nearly 30% of people had cognitive impairment
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Of those with cognitive impairment at the beginning of the study, 20% developed dementia
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Further analysis of the role of type 2 diabetes in the development of dementia, the results found that the important factor affecting the development of dementia is the control of diabetes, rather than diabetes itself
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According to the general recommendation of diabetes treatment guidelines for glucose control goals, HbA1c>7.
5% is considered to be poor blood glucose control in diabetic patients
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In this study, compared with people without diabetes, people with poorly controlled diabetes are twice as likely to suffer from cognitive impairment (HR=2.
01); the possibility of deterioration from cognitive impairment to dementia Sex is 3 times of the former (HR=2.
87)
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Heart disease may be a complication of type 2 diabetes and a sign of more serious diabetes
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Therefore, the researchers also analyzed the risk of cognitive impairment in participants with type 2 diabetes and heart disease (such as atrial fibrillation, heart failure, or coronary artery disease)
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The results found that compared with participants who had neither type 2 diabetes nor heart disease, diabetes combined with heart disease doubled the participants’ risk of cognitive impairment and dementia
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However, having type 2 diabetes or heart disease alone is not associated with a significantly increased risk of dementia
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Abigail Dove, a neurobiology doctor of the Rollinska Institute, the corresponding author of the study pointed out: “There is currently no cure for dementia, so prevention is crucial.
The risk of worsening cognitive impairment (developing to dementia) increases
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"In addition, chronic inflammation of the body is common in patients with type 2 diabetes, cardiovascular disease, and dementia
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The researchers further analyzed the influence of inflammation markers (C-reactive protein) in the development of the disease and found that people with type 2 diabetes and elevated C-reactive protein levels compared with people with normal blood sugar and elevated C-reactive protein levels , The risk of changing from preclinical dementia to dementia is 3 times the former (HR=3.
3)
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Dr.
Abigail Dove explained: “It seems that people with higher levels of C-reactive protein have a faster progression of cognitive impairment.
Systemic inflammation seems to play an important role in it, but more research is needed to verify this conclusion
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"Related reading JAMA 32 years of big data: Diabetes is 10 years earlier, the risk of dementia doubles! How high blood sugar can harm the body? JACC 300,000 people data: If you are slightly too high, you have to beware of several diseases! Early sugar control is too important to determine the risk of death and myocardial infarction in the next 20 years! The milestone study of type 2 diabetes adds evidence to the BMJ review: The benefits of a “low-sugar” diet for diabetic patients are far more than just lowering blood sugar! More people with type 2 diabetes can benefit! Two JAMAs call for more extensive use of continuous blood glucose monitoring reference materials[1] Dove, A.
et al.
, (2021).
The impact of diabetes on cognitive impairment and its progression to dementia.
Alzheimer's & Dementia,DOI: https:// doi.
org/10.
1002/alz.
12482[2] How well-controlled type 2 diabetes is may play a part in dementia risk, says study.
Retrieved OCTOBER 12, 2021, FROM https://medicalxpress.
com/news/2021- 10-well-controlled-diabetes-dementia.
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