December 31, 2013
Elevated A1c Means Elevated Dementia Risk
Are you concerned about dementia? Apparently, many people with type 2 diabetes are not concerned. Questions still need answering. What are doctors doing to help people manage their diabetes? Are patients being informed of the increased risk for dementia by having an A1c above 7.0%? Diabetes is an established risk factor for dementia.
The sad part is our doctors are doing very little to help people manage their diabetes. When it comes to dementia, doctors are not even talking about this. Yes, there are a very few that stay current and inform their patients, but the vast majority could care less. What is even more alarming is the number of patients that do nothing to learn about diabetes and managing their diabetes.
This study is reported in the New England Journal of Medicine. Sandra Adamson Fryhofer, MD reports on this study in Medscape. “The study included more than 2000 patients, about 800 men and 1200 women, with a mean age of 76 years at the start. None had dementia but about 200 of them had diabetes. The rest did not. They were followed for 7 years. Blood sugars and hemoglobin A1c levels were closely monitored. By the end of the study, 524 people had developed dementia, 74 of whom were diabetic. The remainder of those diagnosed with dementia were not.”
The study discovered that patients with higher blood glucose levels on average were more likely to develop dementia. Among people with diabetes, the risk for dementia was 40 percent higher for those averaging around 190 mg/dl when compared to those with average blood glucose levels around 160 mg/dl. Other surprising facts come from the pre-diabetes range. Those with average blood glucose of 115 mg/dl were about 20 percent more likely to develop dementia that those with average blood glucose levels of 100 mg/dl.
Insulin resistance and microvascular disease of the central nervous system may also affect dementia, but these have to be studied. Another factor that needs to be studied is patients at the certain ages may have early onset of dementia that causes them to not take care of their diabetes as well as they might otherwise.
This study does suggest that any increase in blood glucose levels above the normal range increases the risk dementia. For those people with diabetes, the risk for dementia is more elevated. Therefore, it makes preventing dementia even more important by maintaining blood glucose levels at the normal range. This means between 80 to 100 mg/dl or below 5.7% for A1c.
The problem is eating the right foods, keeping weight in the idea range for height and frame size, as well as great management of blood glucose levels.