The Effects of Low Blood Sugar on Alzheimer's Disease and Dementia

New research (from the Journal of the American Medical Association 2009) suggests a link between dangerously low blood sugar and dementia in older patients with type 2 diabetes raises more questions about the strategy of aggressively treating diabetes patients to achieve tight glycaemic control.

Older patients in the study whose blood sugar fell so low that they ended up in the hospital were found to have a higher risk for dementia than patients with no history of treatment for low blood sugar.

Having uncontrolled diabetes is associated with an increased risk for Alzheimer's disease and other age-related dementias in elderly patients but this new study suggests such treatment may do more harm than good in older patients if blood sugar levels drop to very low levels.

Several other recent high-profile studies have raised similar concerns.

Researcher Rachel Whitmer, PhD, of Kaiser Permanente Division of Research in Oakland, Calif., says understanding the impact of blood sugar on cognitive function is older patients is critical.

"We are in the midst of an epidemic of type 2 diabetes and we are going to see more dementia than we have ever seen before as these patients age. We really have to get a handle on the role of glycaemic control in this."

The study included 16,667 patients with type 2 diabetes enrolled in a northern California diabetes registry. The average age of the patients at study entry was 65.

Whitmer and colleagues examined more than two decades of medical records to determine whether the participants had ever been hospitalized or treated in a hospital emergency department for hypoglycaemia.

Symptoms of hypoglycaemia can include dizziness, disorientation, fainting, and even seizures. Mild to moderate episodes often don't require treatment, but severe episodes can lead to hospitalization.

None of the study participants had a diagnosis of dementia when they were enrolled in the study in 2003. Four years later, however, 1,822 of the more than 16,600 patients (11%) had been diagnosed with dementia.

Compared to patients with no history of low blood sugar requiring treatment, patients with a single episode of hospital-treated hypoglycaemia were found to have a 26% increase in dementia risk.

Patients treated three or more times for hypoglycaemia had nearly double the dementia risk of patients who had never been treated.

This confirms what I have been saying in The Alzheimer's Alternative - control your blood sugar and if need be supplement with 200mcg of chromium picolinate!