Long-term average HbA1c greater than 9% in adults with T2DM associated with increased risk of dementia

Question clinique

What is the association between long-term glycemic control and developing dementia in adults with type 2 diabetes mellitus?

L’Essentiel

In this large population-based cohort, older adults with T2DM whose cumulative glycemic control was greater 9% were at increased risk of developing dementia. (LOE = 2b)

Overuse alert:This POEM aligns with the Canadian Geriatric Society’s Choosing Wisely Canada recommendation: Avoid using medications known to cause hypoglycemia to achieve hemoglobin A1c <7.5% in many adults age 65 and older; moderate control is generally better.

Plan de l'etude: Cohort (retrospective)

Financement: Government

Cadre: Population-based

Reviewer

Henry C. Barry, MD, MS
Professor
Michigan State University
East Lansing, MI


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Commentaires

Anonymous

Glycemic control in elderly Type 2 DM

Important new data. a lot of Type 2 mature diabetics don't think tight control is necessary.

ARUP KUMAR DHARA

Impact assessment

Excellent

Anonymous

HbA1c and Dementia

Is the advice then to target HbA1c to 7.5 to 9?

Roland Michael Grad

A sweet spot?

Looks like an a1c of 7.5 to 8.5% is most reasonable, with progressively less concern as we age.