Blood sugar con­trol tied to long-term brain health with Type 1 di­a­betes

Stabroek News Sunday - - CLASSIFIEDS -

(Reuters) - Peo­ple with Type 1 di­a­betes who are able to main­tain good blood sugar con­trol may re­duce their long-term risk of de­vel­op­ing de­men­tia, a U.S. study sug­gests. Among more than 3,400 Type 1 di­a­betes pa­tients in a large health­care sys­tem, those with av­er­age blood glu­cose read­ings near the nor­mal range more than half of the time were 45 per­cent less likely to de­velop de­men­tia than those whose read­ings were rou­tinely higher, the study team re­ports in Di­a­betes Care.

“Peo­ple with Type 1 di­a­betes are liv­ing longer than ever be­fore. This in­crease in life ex­pectancy is ac­com­pa­nied by an in­creased risk of de­vel­op­ing ag­ing-re­lated dis­eases such as de­men­tia,” said lead study au­thor Mary Lacy, a post­doc­toral fel­low at the Univer­sity of Cal­i­for­nia at San Fran­cisco.

The Di­a­betes Con­trol and Com­pli­ca­tions Trial, con­sid­ered a land­mark clin­i­cal trial, found that in­ten­sive di­a­betes ther­apy aimed at achiev­ing glycemic con­trol de­creases the risk for de­vel­op­ing com­pli­ca­tions such as stroke, heart dis­ease, eye dis­ease and vas­cu­lar dis­eases, Lacy’s team notes. The re­searchers are now eval­u­at­ing links be­tween blood sugar con­trol and de­men­tia as well as other age-re­lated dis­eases.

“Given the ag­ing pop­u­la­tion of in­di­vid­u­als with Type 1 di­a­betes and the im­por­tance of cog­ni­tive func­tion in Type 1 di­a­betes self-care, un­der­stand­ing the role of glycemic con­trol on de­men­tia risk is es­pe­cially im­por­tant,” she told Reuters Health by email.

Us­ing health records, the re­searchers fol­lowed 3,433 peo­ple over age 50 with Type 1 di­a­betes who were mem­bers of Kaiser Per­ma­nente North­ern Cal­i­for­nia be­tween 1996 and 2015. The re­search team an­a­lyzed the pa­tients’ re­peated mea­sure­ments of HbA1c, a pro­tein on red blood cells that in­di­cates blood sugar lev­els over a pe­riod of two to three months.

HbA1c read­ings of 5.7 per­cent or less are con­sid­ered healthy and nor­mal, ac­cord­ing to the Na­tional In­sti­tute of Di­a­betes and di­ges­tive and Kid­ney Dis­eases. And lev­els of 6.5 per­cent or more are di­ag­nos­tic of di­a­betes. Peo­ple with Type 1 or Type 2 di­a­betes are en­cour­aged to try to get their blood sugar down and keep it as close to nor­mal lev­els as pos­si­ble.

Half of the study par­tic­i­pants were fol­lowed for 6.5 years or more, and over time, 155 peo­ple, or 4.5 per­cent of the group, were di­ag­nosed with de­men­tia.

Af­ter ad­just­ing for age, sex, race and eth­nic­ity, base­line health con­di­tions, and the fre­quency of blood sugar mea­sure­ments, re­searchers found that pa­tients for whom more than half of HbA1c read­ings were 9 per­cent (75 mmol/mol) or higher, had a 79 per­cent greater risk of de­men­tia com­pared to those with­out such high read­ings most of the time.

Sim­i­larly, pa­tients with more than half of their read­ings be­tween 8 per­cent and 9 per­cent (or 64-74 mmol/mol) had a 65 per­cent higher risk of de­men­tia.

At the other end of the spec­trum, those with more than half of their blood sugar mea­sure­ments be­tween 6 per­cent and 8 per­cent (or 42-63 mmol/mol) had a 45 per­cent lower risk of de­men­tia than peo­ple with higher read­ings more than half of the time.

Over­all, those who de­vel­oped de­men­tia were older when the study started (age 65 ver­sus 55) and were more likely to have a his­tory of stroke. Among those who even­tu­ally de­vel­oped de­men­tia, the av­er­age age at de­men­tia di­ag­no­sis was 65.

“It was re­ally grat­i­fy­ing to see that, gen­er­ally speak­ing, the HbA1c lev­els that were as­so­ci­ated with lower risk of de­men­tia are con­sis­tent with cur­rently rec­om­mended . . . tar­gets,” Lacy said.

Fu­ture stud­ies should look at the mech­a­nisms be­hind blood glu­cose con­trol and de­men­tia risk, which is likely re­lated to struc­tural brain ab­nor­mal­i­ties that come from chronic ex­po­sure to high or low blood sugar, the study au­thors write.

Re­cent re­search has also found an as­so­ci­a­tion be­tween poor glycemic con­trol and de­creased cog­ni­tive func­tion­ing in older adults with Type 2 di­a­betes. The lead au­thor of one of these stud­ies, pub­lished in 2015 in the Jour­nal of Alzheimer’s Dis­ease, who was not in­volved in the cur­rent study, noted that a Type 2 di­a­betes di­ag­no­sis on its own was not linked with de­men­tia risk in his team’s work.

“The di­ag­no­sis, per se, did not in­crease the risk of ei­ther all-cause de­men­tia or Alzheimer’s dis­ease,” said Dr. Al­fredo Ramirez of the Univer­sity of Bonn In­sti­tute of Hu­man Ge­net­ics in Ger­many. “Type 2 di­a­betes mel­li­tus di­ag­no­sis was not as­so­ci­ated with an in­creased risk if HbA1c lev­els were be­low 7 per­cent.”

Newspapers in English

Newspapers from Guyana

© PressReader. All rights reserved.