In the Journals

Severe hypoglycemia contributes to diminished cognitive ability for older adults with type 1 diabetes

Cognitive abilities such as executive function, language and episodic memory are all negatively affected by severe hypoglycemia in adults with type 1 diabetes aged at least 60 years, according to findings published in Diabetes Care.

“With recent advances in treatment, individuals with type 1 diabetes are living longer and are, thus, at increased risk for a number of aging-related diseases, such as cognitive decline and dementia,” Mary E. Lacy, PhD, MPH, assistant professor of epidemiology in the department of epidemiology at the University of Kentucky College of Public Health in Lexington, and colleagues wrote. “Understanding the association between severe hypoglycemia and cognition in older adults with type 1 diabetes is increasingly important given the growing population of older adults with type 1 diabetes and the increased risk of both severe hypoglycemia and cognitive decline in this population.”

Lacy and colleagues used data from 718 participants with type 1 diabetes aged at least 60 years (mean age, 67.21 years; 50.7% women) from the Study of Longevity in Diabetes (SOLID). The number of severe hypoglycemia events in the previous year and hospitalizations due to hypoglycemia at any time were self-reported. According to the researchers, these were categorized as “recent severe hypoglycemia” and “lifetime severe hypoglycemia history,” respectively. Cognitive tests for language, executive function, episodic memory and simple attention were completed by participants, and the researchers combined test results to determine global cognition.

brain 
Cognitive abilities such as executive function, language and episodic memory are all negatively affected by severe hypoglycemia in adults with type 1 diabetes aged at least 60 years.
Source: Shutterstock

Participants with the most (four or more) recent events of severe hypoglycemia and those with the highest rates of lifetime hypoglycemia had the worst test results and those with no recent events and with the lowest lifetime rates had the best scores for global cognition, executive function and episodic memory (P < .01 for all), according to the researchers. Compared with participants who reported no severe hypoglycemia events, those with four or more recent events had increased odds of global cognition impairment (OR = 3.1; 95% CI, 1.26-7.63) and impaired language (OR = 3.08; 95% CI, 1.17-8.08).

“These findings suggest that, in older adults with type 1 diabetes, recent severe hypoglycemia exposures contribute to cognitive risk independent of prior adverse effects on the brain from past severe hypoglycemia exposures,” the researchers wrote. “Our findings underscore the importance of continued vigilance and management to prevent severe hypoglycemia in this older population, as the aging brain may be particularly susceptible to severe hypoglycemia-related cognitive decline.” – by Phil Neuffer

Disclosures: The authors report no relevant financial disclosures.

Cognitive abilities such as executive function, language and episodic memory are all negatively affected by severe hypoglycemia in adults with type 1 diabetes aged at least 60 years, according to findings published in Diabetes Care.

“With recent advances in treatment, individuals with type 1 diabetes are living longer and are, thus, at increased risk for a number of aging-related diseases, such as cognitive decline and dementia,” Mary E. Lacy, PhD, MPH, assistant professor of epidemiology in the department of epidemiology at the University of Kentucky College of Public Health in Lexington, and colleagues wrote. “Understanding the association between severe hypoglycemia and cognition in older adults with type 1 diabetes is increasingly important given the growing population of older adults with type 1 diabetes and the increased risk of both severe hypoglycemia and cognitive decline in this population.”

Lacy and colleagues used data from 718 participants with type 1 diabetes aged at least 60 years (mean age, 67.21 years; 50.7% women) from the Study of Longevity in Diabetes (SOLID). The number of severe hypoglycemia events in the previous year and hospitalizations due to hypoglycemia at any time were self-reported. According to the researchers, these were categorized as “recent severe hypoglycemia” and “lifetime severe hypoglycemia history,” respectively. Cognitive tests for language, executive function, episodic memory and simple attention were completed by participants, and the researchers combined test results to determine global cognition.

brain 
Cognitive abilities such as executive function, language and episodic memory are all negatively affected by severe hypoglycemia in adults with type 1 diabetes aged at least 60 years.
Source: Shutterstock

Participants with the most (four or more) recent events of severe hypoglycemia and those with the highest rates of lifetime hypoglycemia had the worst test results and those with no recent events and with the lowest lifetime rates had the best scores for global cognition, executive function and episodic memory (P < .01 for all), according to the researchers. Compared with participants who reported no severe hypoglycemia events, those with four or more recent events had increased odds of global cognition impairment (OR = 3.1; 95% CI, 1.26-7.63) and impaired language (OR = 3.08; 95% CI, 1.17-8.08).

“These findings suggest that, in older adults with type 1 diabetes, recent severe hypoglycemia exposures contribute to cognitive risk independent of prior adverse effects on the brain from past severe hypoglycemia exposures,” the researchers wrote. “Our findings underscore the importance of continued vigilance and management to prevent severe hypoglycemia in this older population, as the aging brain may be particularly susceptible to severe hypoglycemia-related cognitive decline.” – by Phil Neuffer

Disclosures: The authors report no relevant financial disclosures.