Very Low Blood Sugar Linked to Dementia
Study Raises Concerns About Aggressive Diabetes Treatment in Older Patients
April 17, 2009 -- New research that suggests a link between dangerously low blood sugar and dementia in older patients with type 2 diabetes raises more questions about the strategy of aggressively treating diabetes patients to achieve tight glycemic control.
Older patients in the study whose blood sugar fell so low that they ended up in the hospital were found to have a higher risk for dementia than patients with no history of treatment for low blood sugar, known medically as hypoglycemia.
Having uncontrolled diabetes is associated with an increased risk for Alzheimer's disease and other age-related dementias in elderly patients.
The thinking has been that aggressive treatment to achieve tight glycemic control would lower this risk.
But the new study suggests such treatment may do more harm than good in older patients if blood sugar levels drop to very low levels.
Several other recent high-profile studies have raised similar concerns.
Researcher Rachel Whitmer, PhD, of Kaiser Permanente Division of Research in Oakland, Calif., says understanding the impact of blood sugar on cognitive function is older patients is critical.
"We are in the midst of an epidemic of type 2 diabetes and we are going to see more dementia than we have ever seen before as these patients age," she tells WebMD. "We really have to get a handle on the role of glycemic control in this."