Diabetic ketoacidosis further increases risk of Alzheimer's disease in patients with type 2 diabetes

doi:10.1016/j.diabres.2018.11.013

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Title:	Diabetic ketoacidosis further increases risk of Alzheimer's disease in patients with type 2 diabetes
Authors:	Chen, Yu-Li Weng, Shih-Feng Yang, Chwen-Yi Wang, Jhi-Joung Kai-Jen Tien(田凱仁)
Contributors:	Chi Mei Med Ctr, Dept Internal Med, Div Endocrinol & Metab, Chia Li Branch Kaohsiung Med Univ, Dept Healthcare Adm & Med Informat Chi Mei Med Ctr, Dept Internal Med, Div Endocrinol & Metab Chi Mei Med Ctr, Dept Med Res Chia Nan Univ Pharm & Sci, Dept Senior Citizen Serv Management
Keywords:	Type 2 diabetes Diabetic ketoacidosis Dementia
Date:	2019-01
Issue Date:	2020-07-29 13:54:09 (UTC+8)
Publisher:	ELSEVIER IRELAND LTD
Abstract:	Aim: Diabetes mellitus (DM) is a known risk factor for dementia. It is unclear whether diabetic ketoacidosis (DKA) further increases the risk of dementia in patients with type 2 DM. Methods: This retrospective nationwide population-based cohort study was conducted using Taiwan's National Health Insurance database. We extracted claims data for 4451 patients with type 2 diabetes and DKA and 8902 diabetic controls matched for age, gender, diabetes complication severity index, frequency of clinic visits and baseline comorbidities between 2000 and 2002. Patients with type 1 diabetes or prior hypoglycemia before index date were excluded. All patients were tracked until new dementia diagnosis, death, or end of 2011. Results: Of the 4451 DKA patients, 211 (4.7%) and 305 (3.4%) of the 8902 diabetic controls were diagnosed as having dementia during the follow-up period. The incidence rate ratio (IRR) for dementia was 1.62 (95% CI 1.35-1.93; P < 0.0001) for patients with DKA versus diabetic patients without DKA. After adjusting for age, baseline comorbidities, geographic area, and income, patients with DKA were found to have 1.86 times the risk of developing dementia, compared to controls (95% CI 1.56-2.22, P < 0.0001). They were found to have a higher risk of Alzheimer's dementia (HR: 1.86; 95% CI 1.52-2.28, P < 0.0001) but not non-Alzheimer's dementia. Conclusion: Type 2 diabetes patients with DKA are at increased risk of Alzheimer's dementia but not non-Alzheimer dementia. (C) 2018 Elsevier B. V. All rights reserved.
Relation:	Diabetes Research and Clinical Practice, v147, pp.55-61
Appears in Collections:	[Dept. of Senior Service and Health Management] Periodical Articles

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