Imperial College London
Alternate

Professor Lefkos Middleton

Faculty of Medicine, School of Public Health

Chair in Clinical Neurology
 
 
 
//

Contact

 

+44 (0)20 3311 7290l.middleton CV

 
 
//

Assistant

 

Ms Naia Headland-Vanni +44 (0)20 3311 7290

 
//

Location

 

Room 10L05 LaboratoryCharing Cross HospitalCharing Cross Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Zheng:2021:10.2337/dc20-2850,
author = {Zheng, B and Su, B and Price, G and Tzoulaki, I and Ahmadi-Abhari, S and Middleton, L},
doi = {10.2337/dc20-2850},
journal = {Diabetes Care},
pages = {1556--1563},
title = {Glycemic control, diabetic complications, and risk of dementia in patients with diabetes: results from a large UK cohort study},
url = {http://dx.doi.org/10.2337/dc20-2850},
volume = {44},
year = {2021}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - OBJECTIVE Type 2 diabetes is an established risk factor for dementia. However, the roles of glycemic control and diabetic complications in the development of dementia have been less well substantiated. This large-scale cohort study aims to examine associations of longitudinal HbA1c levels and diabetic complications with the risk of dementia incidence among patients with type 2 diabetes.RESEARCH DESIGN AND METHODS Data of eligible patients with diabetes, aged ≥50 years in the U.K. Clinical Practice Research Datalink from 1987 to 2018, were analyzed. Time-varying Cox regressions were used to estimate adjusted hazard ratios (HRs) and 95% CIs for dementia risk.RESULTS Among 457,902 patients with diabetes, 28,627 (6.3%) incident dementia cases were observed during a median of 6 years’ follow-up. Patients with recorded hypoglycemic events or microvascular complications were at higher risk of dementia incidence compared with those without such complications (HR 1.30 [95% CI 1.22–1.39] and 1.10 [1.06–1.14], respectively). The HbA1c level, modeled as a time-varying exposure, was associated with increased dementia risk (HR 1.08 [95% CI 1.07–1.09] per 1% HbA1c increment) among 372,287 patients with diabetes with postdiagnosis HbA1c records. Similarly, a higher coefficient of variation of HbA1c during the initial 3 years of follow-up was associated with higher subsequent dementia risk (HR 1.03 [95% CI 1.01–1.04] per 1-SD increment).CONCLUSIONS Higher or unstable HbA1c levels and the presence of diabetic complications in patients with type 2 diabetes are associated with increased dementia risk. Effective management of glycemia might have a significant role in maintaining cognitive health among older adults with diabetes.
AU  - Zheng,B
AU  - Su,B
AU  - Price,G
AU  - Tzoulaki,I
AU  - Ahmadi-Abhari,S
AU  - Middleton,L
DO  - 10.2337/dc20-2850
EP  - 1563
PY  - 2021///
SN  - 0149-5992
SP  - 1556
TI  - Glycemic control, diabetic complications, and risk of dementia in patients with diabetes: results from a large UK cohort study
T2  - Diabetes Care
UR  - http://dx.doi.org/10.2337/dc20-2850
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000678813200019&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://care.diabetesjournals.org/content/44/7/1556
UR  - http://hdl.handle.net/10044/1/91537
VL  - 44
ER  -
Download