The risk of death increases fivefold in diabetic patients if they have severe hypoglycemia and dementia, a study found.
Hypoglycemia is a low blood glucose level. Severe hypoglycemia, which is the most dangerous level among the hypoglycemic stages classified by the Korean Diabetes Association, refers to a hypoglycemic shock state that the patient cannot cope with on his own.
A research team led by Professor Lee Yong-ho of the Department of Endocrinology at Severance Hospital and Professor Yu-jin Han of the Department of Endocrinology at Keimyung University Daegu Dongsan Hospital revealed that the risk of dementia and death increased by 50% and 29%, respectively, if type 2 diabetes patients were treated for severe hypoglycemia at least once. In particular, if you have both severe hypoglycemia and dementia, the risk of death increases by 5.1 times.
Using data from the National Health Insurance Corporation, the research team analyzed the number of treatments for severe hypoglycemia from 2006 to 2009 for 2 million people with type 2 diabetes over the age of 40 without dementia in 2009. 14,443 patients (0.7%) were treated at least once for severe hypoglycemia.
The research team then investigated the cases of dementia among patients during a follow-up period of about 7 years until December 2015.
As a result, the greater the number of treatments for severe hypoglycemia, the higher the risk of dementia. The risk of dementia was 1.5 times higher in the single treatment group and 1.8 times higher in the two or more treatments compared with patients without severe hypoglycemia.
By dementia type, the risk of senile dementia (Alzheimer’s disease) increased by 1.5 times in the single treatment group, 1.9 times in the 2 or more treatment groups, and the risk of vascular dementia by 1.5 times in the single treatment group and 1.4 times in the 2 or more treatment groups, respectively. By age group, the increase was 3.1 times in the group under 60 years old and 1.6 times in the group over 60 years old.
The research team identified deaths by 2015 among diabetic patients with dementia in 2009. The death toll was 51,567. The risk of death was increased by 29% in the first treatment group and by 35% in the second treatment group compared to patients without severe hypoglycemia.
As a result of analyzing the risk of death due to dementia and severe hypoglycemia, the risk of death in diabetic patients diagnosed with dementia and treated for severe hypoglycemia was 5.1 times higher than in patients without both diseases.
The risk of death was doubled in dementia patients without severe hypoglycemia, and the risk of death was 4.3 times higher in patients who received treatment for severe hypoglycemia but did not have dementia.
Professor Lee Yong-ho said, “It is as important for diabetic patients to prevent hypoglycemia as is as important as controlling hyperglycemia.
It is important for diabetic patients with hypoglycemia to consume the right amount on a regular basis. If the amount and time of meals is changed frequently, the basal metabolic rate decreases and it is easy to overeat, making it difficult to control blood sugar.
It is also important to maintain an appropriate weight through exercise. It is good to stretch frequently to relax the muscles and to do light exercise during daily life. It is also important to prepare for an emergency by notifying family and friends of the symptoms of hypoglycemia and how to deal with it in advance.
The research results were published in the latest issue of ‘Journal of Clinical Endocrinology & Metabolism’, an official academic journal of the American Endocrinology Association.
Kwon Dae-ik medical journalist [email protected]