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Association of hyperglycemia episodes on long-term mortality in type 2 diabetes mellitus with vascular dementia: A population-based cohort study
Authors:Chun-Lin Liu  Ming-Yen Lin  Shang-Jyh Hwang  Ching-Kuan Liu  Huei-Lan Lee  Ming-Tsang Wu
Affiliation:1. Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;2. Calo Psychiatric Center, Pingtung County, Taiwan;3. Department of Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;4. Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;5. Master of Public Health Degree Program, College of Public Health, National Taiwan University, Taipei, Taiwan;6. Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan;7. Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;8. Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan;9. Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
Abstract:

Aim

This study investigated the effect of severe hyperglycemia episodes on survival and associated factors related to risk of mortality in type 2 diabetes mellitus (DM) patients with dementia.

Methods

We enrolled all type 2 DM patients newly diagnosed as having dementia in Taiwan from 1998 to 2005. These patients were categorized into those who had hyperglycemia episodes and those who did not based on whether or not they had been hospitalized for hyperglycemia after dementia diagnosis. Factors independently associated with mortality were evaluated.

Results

Of 5314 patients identified, 303 (5.7%) had at least one hyperglycemia hospitalization. Patients with at least one hyperglycemia hospitalization had a 30% greater risk of mortality than those who had no such admissions (adjusted hazard ratio: 1.30, 95% confidence interval: 1.09–1.55). Other variables, including age, sex, geographical region, insurance amount, patient with congestive heart failure, cerebrovascular disease, renal disease, use of anti-hypertensive drugs, use of anti-lipid drugs, and use of insulin were independently associated with risk of mortality.

Conclusion

Severe hyperglycemia is common in type 2 DM patients with dementia and it substantially shortens their life. The findings of this study suggest a great need to improve care in DM patients with dementia.
Keywords:Dementia  Diabetes mellitus  Morbidity  Hyperglycemia  Mortality
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