A recent study published in JAMA Network Open has revealed that maintaining stable blood sugar levels within personalized target ranges may help reduce the risk of Alzheimer’s disease and related dementias (ADRD) in older adults with diabetes.
This research highlights the importance of individualized care in managing diabetes to potentially prevent cognitive decline.
The study, led by Dr. Patricia C. Underwood from the William F. Connell School of Nursing at Boston College, focused on older veterans with diabetes. Researchers analyzed data from 374,021 veterans who were tracked over a period of up to 10 years.
These veterans were identified from administrative healthcare data collected between 2005 and 2014. The study aimed to examine the relationship between the stability of glycated hemoglobin (HbA1c) levels—an indicator of long-term blood sugar control—and the incidence of ADRD.
HbA1c levels reflect the average blood glucose concentration over the past two to three months, offering insight into how well a person’s diabetes is managed.
The researchers specifically looked at “time in range” (TIR), which refers to the percentage of time a person’s HbA1c levels stay within a target range. They found that veterans who had lower TIR, meaning their HbA1c levels were often outside of their target range, were at a higher risk of developing ADRD.
Specifically, those with an HbA1c TIR of less than 20% had a 19.3% higher risk of developing ADRD compared to those whose HbA1c levels were within the target range at least 80% of the time.
Moreover, the study discovered that not only the frequency but also the direction of out-of-range HbA1c levels mattered. Veterans who spent more time with their HbA1c levels below the target range—indicating potential episodes of hypoglycemia or low blood sugar—had a significantly higher risk of ADRD.
The increased risk was particularly notable in those who experienced more time with blood sugar levels below the target range, showing a 23% higher risk of developing ADRD.
Interestingly, the findings remained significant even after excluding individuals who were taking medications known to increase the risk of hypoglycemia, such as insulin and sulfonylureas, or who had already experienced hypoglycemia events.
This suggests that the stability of HbA1c levels themselves, rather than just medication-related factors, plays a critical role in influencing the risk of dementia.
The study’s authors emphasize the importance of personalized care in managing diabetes, particularly in older adults. They argue that HbA1c target ranges should be tailored to each individual, considering factors such as age, life expectancy, and the presence of other health conditions.
By doing so, clinicians can help ensure that blood sugar levels remain stable, potentially lowering the risk of ADRD.
These findings underscore the broader implications of diabetes management on cognitive health. As the population ages, the intersection of diabetes and dementia is becoming an increasingly important area of study.
This research adds to the growing evidence that good diabetes control may offer benefits beyond just physical health, extending to the protection of cognitive function in older adults.
In conclusion, maintaining stable blood sugar levels within personalized target ranges appears to be associated with a lower risk of developing Alzheimer’s disease and related dementias in older adults with diabetes.
This study suggests that clinicians should work closely with patients to manage their HbA1c levels effectively, as part of a broader strategy to prevent cognitive decline in this vulnerable population.
If you care about diabetes, please read studies about diabetes and vitamin B12, and the right diet for people with type 2 diabetes.
For more health information, please see recent studies about how to eat smart with diabetes, and turmeric and vitamin D: a duo for blood pressure control in diabetic patients.
The research findings can be found in JAMA Network Open.
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