Glycemic control and disability-free survival in hypoglycemic agent-treated community-dwelling older patients with type 2 diabetes mellitus

Background: The adequate glycemic control and risk factors for hypoglycemia in older patients with dementia and type 2 diabetes mellitus (T2DM) remain unclear. This study aimed to analyze the status of glycemic control and determine the risk of hypoglycemia among these groups. Methods: A hospital admission record due to hypoglycemia through an emergency room with glucose supplementation in the Chang Gung Memorial Hospital was identified as a hypoglycemic event. Patients with dementia and T2DM without hypoglycemic events throughout the study period were defined as the control group. We gathered patients aged ≥65 years with a diagnosis of Alzheimer’s dementia (AD) and T2DM between 2001 and 2018 in the Chang Gung Research Database (CGRD). We extracted data included medication use, diagnoses, and biochemistry data from hospital records. Results: A total of 3877 older patients with dementia and T2DM with regular visits to the outpatient department were enrolled in this study. During the two-year follow-up period, 494 participants (12.7%) experienced hypoglycemia. Multivariable logistic multivariable regression models for hypoglycemic events showed that metformin had a protective effect (odds ratio (OR) = 0.75, p = 0.023), insulin had the highest risk (OR = 4.64, p < 0.001). Hemoglobin A1c (HbA1c) levels were not correlated with hypoglycemic events (OR = 0.95, p = 0.140). Patients with hypoglycemic episodes had a significantly higher proportion of ≥2 Charlson Comorbidity Index scores than those without hypoglycemic episodes (83.2% versus 56.4%, p < 0.001). Conclusions: Drug regimen affects hypoglycemic episodes but not HbA1c in older patients with dementia and T2DM. In addition, patients with more comorbidities experience an increased risk of hypoglycemia.

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Effect of Poor Glycemic Control Incognitive Performance Inthe Elderly With Type 2 Diabetes Mellitus: The Mexican Health and Aging Study

10.21203/rs.3.rs-44732/v1 ◽

2020 ◽

Author(s):

Alberto J Mimenza-Aguilar ◽

Gilberto A Jimenez-Castillo ◽

Sara G Yeverino-Castro ◽

Abel Barragán-Berlanga ◽

Mario U Perez-Zepeda ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Glycemic Control ◽

Cognitive Performance ◽

Multinomial Logistic Regression ◽

Community Dwelling ◽

Elderly Persons ◽

Aging Study

Abstract Background Cognitive impairment is twice more frequent in elderly with type 2 diabetes mellitus (DM). This study was conducted to determine the association between glycemic control and cognitive performance among community-dwelling elderly persons in Mexico. Methods Cross-sectional study conducted in individuals aged 60 years or elderly participating in the 2012 Mexican Health and Aging Study. Type 2 DM participants were classified in 3 groups according to their glycated hemoglobin levels (HbA1c): <7% (intensive control), 7-7.9% (standard control) or ≥ 8% (poor control), and cognitive performance: low (CCCE ≤ 44 points), intermediate (44.1-59.52 points), or high (≥ 59.53 points). Multinomial logistic regression models were constructed to determine this association. Results Out of 946 subjects, 216 were selected. Subjects in the low cognitive performance group were older (69.7 ± 6.6 vs 65.86 ± 5.18 years, p < .001) and had a lower educational level (2.5 ± 2.6 vs 7.44 ± 4.15 years, p < .000) when compared to the high cognitive performance participants. HbA1c ≥8% was associated with having low (OR 3.17, 95% CI 1.17–8.60, p = .024), and intermediate (OR 3.23, 95% CI 1.27–8.20, p = .014) cognitive performance; this trend was not found for HbA1c 7.0-7.9% group. Conclusions Glycemic control with a HbA1c ≥ 8% was associated with worse cognitive performance.

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Effect of poor glycemic control in cognitive performance in the elderly with type 2 diabetes mellitus: The Mexican Health and Aging Study

BMC Geriatrics ◽

10.1186/s12877-020-01827-x ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Alberto J. Mimenza-Alvarado ◽

Gilberto A. Jiménez-Castillo ◽

Sara G. Yeverino-Castro ◽

Abel J. Barragán-Berlanga ◽

Mario U. Pérez-Zepeda ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Glycemic Control ◽

Cognitive Performance ◽

Community Dwelling ◽

Poor Glycemic Control ◽

Elderly Persons ◽

Aging Study

Abstract Background Cognitive impairment is twice more frequent in elderly with type 2 diabetes mellitus (DM). This study was conducted to determine the association between glycemic control and cognitive performance among community-dwelling elderly persons in Mexico. Methods Cross-sectional study conducted in individuals aged 60 years or elderly participating in the 2012 Mexican Health and Aging Study. Type 2 DM participants were classified in 3 groups according to their glycated hemoglobin levels (HbA1c): < 7% (intensive control), 7–7.9% (standard control) or ≥ 8% (poor control), and cognitive performance: low (CCCE ≤44 points), intermediate (44.1–59.52 points), or high (≥59.53 points). Multinomial logistic regression models were constructed to determine this association. Results Two hundred sixteen community-dwelling adults aged 60 and older with type 2 diabetes were selected. Subjects in the low cognitive performance group were older (69.7 ± 6.6 vs 65.86 ± 5.18 years, p < .001) and had a lower educational level (2.5 ± 2.6 vs 7.44 ± 4.15 years, p < .000) when compared to the high cognitive performance participants. HbA1c ≥ 8% was associated with having low (Odds Ratio (OR) 3.17, 95% CI 1.17–8.60, p = .024), and intermediate (OR 3.23, 95% CI 1.27–8.20, p = .014) cognitive performance; this trend was not found for HbA1c 7.0–7.9% group. The multinomial regression analysis showed that the presence of HbA1c ≥ 8% (poor glycemic control) was associated with low (OR 3.17, 95% CI = 1.17–8.60, p = .024), and intermediate (OR 3.23, 95% CI = 1.27–8.20, p = .014) cognitive performance. After adjusting for confounding variables. Conclusions Glycemic control with a HbA1c ≥ 8% was associated with worse cognitive performance.

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Does comorbidity affect the benefit of intensive glycemic control in older patients with type 2 diabetes mellitus?

Nature Clinical Practice Endocrinology &#38 Metabolism ◽

10.1038/ncpendmet1041 ◽

2008 ◽

Vol 5 (2) ◽

pp. 78-79 ◽

Cited By ~ 1

Author(s):

Christopher D Saudek ◽

Rita R Kalyani

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Glycemic Control ◽

Older Patients ◽

Intensive Glycemic Control

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Effect of poor glycemic control in Cognitive Performance in the elderly with type 2 diabetes mellitus: The Mexican Health and Aging Study

10.21203/rs.3.rs-44732/v2 ◽

2020 ◽

Author(s):

Alberto J Mimenza-Aguilar ◽

Gilberto A Jimenez-Castillo ◽

Sara G Yeverino-Castro ◽

Abel Barragán-Berlanga ◽

Mario U Perez-Zepeda ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Glycemic Control ◽

Cognitive Performance ◽

Community Dwelling ◽

Poor Glycemic Control ◽

Elderly Persons ◽

Aging Study

Abstract BackgroundCognitive impairment is twice more frequent in elderly with type 2 diabetes mellitus (DM). This study was conducted to determine the association between glycemic control and cognitive performance among community-dwelling elderly persons in Mexico.MethodsCross-sectional study conducted in individuals aged 60 years or elderly participating in the 2012 Mexican Health and Aging Study. Type 2 DM participants were classified in 3 groups according to their glycated hemoglobin levels (HbA1c): <7% (intensive control), 7-7.9% (standard control) or ≥ 8% (poor control), and cognitive performance: low (CCCE ≤44 points), intermediate (44.1-59.52 points), or high (≥59.53 points). Multinomial logistic regression models were constructed to determine this association.Results216 community-dwelling adults aged 60 and older with type 2 diabetes were selected. Subjects in the low cognitive performance group were older (69.7 ± 6.6 vs 65.86 ± 5.18 years, p <.001) and had a lower educational level (2.5 ± 2.6 vs 7.44 ± 4.15 years, p <.000) when compared to the high cognitive performance participants. HbA1c ≥8% was associated with having low (Odds Ratio (OR) 3.17, 95% CI 1.17-8.60, p=.024), and intermediate (OR 3.23, 95% CI 1.27-8.20, p=.014) cognitive performance; this trend was not found for HbA1c 7.0-7.9% group.The multinomial regression analysis showed that the presence of HbA1c ≥8% (poor glycemic control) was associated with low (OR 3.17, 95% CI = 1.17-8.60, p=.024), and intermediate (OR 3.23, 95% CI = 1.27-8.20, p=.014) cognitive performance. After adjusting for confounding variables.ConclusionsGlycemic control with a HbA1c ≥ 8% was associated with worse cognitive performance.

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