T2D treatment, weight gain influence dementia risk in diabetic patients
Type 2 diabetes (T2D) is an independent risk factor for all-cause dementia, with the greatest risk observed in patients who are insulin-dependent and obese, a recent study has found.
Researchers used claims data (n=250,000) of the largest public sickness fund in Germany and identified 142,012 T2D patients aged ≥60 years, representing 612,027 person-years at risk. A total of 12,784 patients developed dementia during the observational period.
The incidence of dementia was lowest in individuals without diabetes (17.8 new cases per 1,000 person-years) relative to diabetic patients without medical treatment (33.5 new cases), diabetic patients treated with oral glucose-lowering medication (23 new cases) and insulin-dependent diabetic patients (28.4 new cases).
In multivariable Cox proportional hazard models, the risk of dementia was 23-percent higher in untreated diabetic patients (hazard ratio [HR], 1.23, 95 percent CI, 1.17–1.28; p<0.001) and 16-percent higher in patients on oral glucose-lowering medications (HR, 1.16, 1.09–1.24; p<0.001) compared with nondiabetic controls.
The highest risk of dementia was observed in insulin-dependent patients (HR, 1.40, 1.31–1.50; p<0.001). Obesity additionally compounded this risk (75 percent; p<0.001).
The findings suggest that different forms of T2D treatment may affect the development of dementia, with weight gain seemingly intensifying this effect, according to the researchers. Large and longitudinal intervention trials with detailed drug information are needed to establish whether well-controlled antidiabetic drug intervention and weight reduction could prevent the development of cognitive decline.