Evidence map›Paper›PMID 27784724›Full record

ArticleThe journals of gerontology. Series A, Biological sciences and medical sciences2017

Association of Hypoglycemia With Subsequent Dementia in Older Patients With Type 2 Diabetes Mellitus.

Hemalkumar B Mehta, Vinay Mehta, James S Goodwin

Erratum issuedOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The journals of gerontology. Series A, Biological sciences and medical sciences, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 33 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 4 pooled it
4.0field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 4 syntheses or guidelines pooled it, 67 citations in OpenAlex.

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  16. Persistent Postgastrectomy Hypoglycemia Unawareness in Patients With Gastric Cancer Unveiled by a Prospective Study.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2022
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 1 country.

Hemalkumar B MehtaDepartment of Surgery, University of Texas Medical Branch, Galveston.
Vinay MehtaMerck, Kenilworth, New Jersey.
James S GoodwinDepartment of Internal Medicine, University of Texas Medical Branch, Galveston.
The University of Texas Medical Branch at Galveston · USMerck & Co., Inc., Rahway, NJ, USA (United States) · US

Funding

Patient Centered Outcomes Research in the ElderlyR24HS022134 · AHRQ · UNIVERSITY OF TEXAS MED BR GALVESTON · PI GOODWIN, MD, JAMES S. · 2013 to 2017
$4.8M
Established Investigator Award in Cancer Prevention & ControlK05CA134923 · NCI · UNIVERSITY OF TEXAS MED BR GALVESTON · PI GOODWIN, MD, JAMES S. · 2008 to 2019
$1.0M
AHRQ HHS R24 HS022134
6 · The paper itself

Abstract

backgroundStudies have found conflicting evidence regarding the association of hypoglycemia with dementia. We evaluated an association of hypoglycemia with subsequent dementia in patients with type 2 diabetes.

methodsThis retrospective longitudinal cohort study used the Clinical Practice Research Datalink, an electronic medical records data from the United Kingdom, from 2003 to 2012. We included patients aged >65 years diagnosed with type 2 diabetes, with no prior diagnosis of dementia. Dementia was defined using diagnosis codes from medical records. All patients were followed from the date of initial diabetes diagnosis. To account for competing risk of death, we used Fine and Gray's competing risk model to determine the association of hypoglycemia with dementia while adjusting for potential confounders. Hypoglycemia was modeled as a time-dependent covariate.

resultsOf 53,055 patients, 5.7% (n = 3,018) had at least one hypoglycemia episodes. The overall incidence rate of dementia was 12.7 per 1,000 person-years. In the fully adjusted model that controlled for all confounders, the occurrence of at least one hypoglycemia episode was associated with 27% higher odds of subsequent dementia (hazard ratio = 1.27; 95% confidence interval = 1.06-1.51). The risk increased with the number of hypoglycemia episodes: one episode (hazard ratio = 1.26; 95% confidence interval = 1.03-1.54); two or more episodes (hazard ratio = 1.50; 95% confidence interval = 1.09-2.08).

conclusionsHypoglycemia is associated with a higher risk of dementia and may be responsible in part for the higher risk of dementia in patients with diabetes. Alternatively, hypoglycemia may be a marker for undiagnosed cognitive impairment, and we cannot rule out the possibility of reverse causation between hypoglycemia and dementia.

Indexed as

DementiaDiabetes Mellitus, Type 2HypoglycemiaAgedCognitionElectronic Health RecordsFemaleHumansHypoglycemic AgentsMaleProportional Hazards ModelsRisk AssessmentSurvival AnalysisUnited KingdomHypoglycemic AgentsCognitive impairmentDementiaHypoglycemiaType 2 diabetes

Identifiers

PMID27784724
PMCPMC5861972
OpenAlexW2541964269

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.