Title | Glucose Peaks and the Risk of Dementia and 20-Year Cognitive Decline. |
Publication Type | Journal Article |
Year of Publication | 2017 |
Authors | Rawlings AM, Sharrett ARichey, Mosley TH, Ballew SH, Deal JA |
Secondary Authors | Selvin E |
Journal | Diabetes Care |
Volume | 40 |
Issue | 7 |
Pagination | 879-886 |
Date Published | 2017 07 |
ISSN | 1935-5548 |
Keywords | Atherosclerosis, Blood Glucose, Cognitive Dysfunction, Dementia, Diabetes Mellitus, Female, Glycated Hemoglobin A, Humans, Hypoglycemic Agents, Male, Middle Aged, Proportional Hazards Models, Risk Factors, Treatment Outcome |
Abstract | OBJECTIVE: Hemoglobin A (HbA), a measure of average blood glucose level, is associated with the risk of dementia and cognitive impairment. However, the role of glycemic variability or glucose excursions in this association is unclear. We examined the association of glucose peaks in midlife, as determined by the measurement of 1,5-anhydroglucitol (1,5-AG) level, with the risk of dementia and 20-year cognitive decline. RESEARCH DESIGN AND METHODS: Nearly 13,000 participants from the Atherosclerosis Risk in Communities (ARIC) study were examined. Dementia was ascertained from surveillance, neuropsychological testing, telephone calls with participants or their proxies, or death certificate dementia codes. Cognitive function was assessed using three neuropsychological tests at three visits over 20 years and was summarized as scores. We used Cox and linear mixed-effects models. 1,5-AG level was dichotomized at 10 μg/mL and examined within clinical categories of HbA. RESULTS: Over a median time of 21 years, dementia developed in 1,105 participants. Among persons with diabetes, each 5 μg/mL decrease in 1,5-AG increased the estimated risk of dementia by 16% (hazard ratio 1.16, = 0.032). For cognitive decline among participants with diabetes and HbA CONCLUSIONS: Among participants with diabetes, glucose peaks are a risk factor for cognitive decline and dementia. Targeting glucose peaks, in addition to average glycemia, may be an important avenue for prevention. |
DOI | 10.2337/dc16-2203 |
Alternate Journal | Diabetes Care |
PubMed ID | 28500217 |
PubMed Central ID | PMC5481977 |
Grant List | HHSN268201100012C / HL / NHLBI NIH HHS / United States HHSN268201100009I / HL / NHLBI NIH HHS / United States U01 HL096812 / HL / NHLBI NIH HHS / United States HHSN268201100010C / HL / NHLBI NIH HHS / United States HHSN268201100008C / HL / NHLBI NIH HHS / United States P50 AG005146 / AG / NIA NIH HHS / United States HHSN268201100005G / HL / NHLBI NIH HHS / United States U01 HL096917 / HL / NHLBI NIH HHS / United States HHSN268201100008I / HL / NHLBI NIH HHS / United States R01 DK089174 / DK / NIDDK NIH HHS / United States HHSN268201100007C / HL / NHLBI NIH HHS / United States HHSN268201100011I / HL / NHLBI NIH HHS / United States HHSN268201100011C / HL / NHLBI NIH HHS / United States U01 HL075572 / HL / NHLBI NIH HHS / United States U01 HL096902 / HL / NHLBI NIH HHS / United States T32 HL007024 / HL / NHLBI NIH HHS / United States HHSN268201100006C / HL / NHLBI NIH HHS / United States HHSN268201100005I / HL / NHLBI NIH HHS / United States K24 DK106414 / DK / NIDDK NIH HHS / United States U01 HL096814 / HL / NHLBI NIH HHS / United States HHSN268201100009C / HL / NHLBI NIH HHS / United States R01 HL070825 / HL / NHLBI NIH HHS / United States HHSN268201100005C / HL / NHLBI NIH HHS / United States U01 HL096899 / HL / NHLBI NIH HHS / United States HHSN268201100007I / HL / NHLBI NIH HHS / United States |