Hypoglycemic Episodes and Risk of Dementia in Older Patients With Type 2 Diabetes Mellitus

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Abstract
A wealth of evidence indicates that patients with diabetes mellitus are at increased risk of dementia.1-4 However, the role of complications of diabetes as possible mechanisms in dementia has not been well studied.5 Hypoglycemia is a potential adverse effect of diabetes treatment, induced either by excess exogenous insulin or by excess endogenous insulin resulting from treatment with insulin secretagogues.6 Although some studies have reported an association between history of hypoglycemia and impaired cognitive functioning in children and young adults with type 1 diabetes,7-10 results from the Diabetes Control and Complications Trial11 found no association between acute hypoglycemia and an accelerated rate of cognitive decline. To date, no research has evaluated whether or to what extent hypoglycemic episodes are a risk factor for development of dementia in populations of older patients, most of whom have type 2 diabetes.