ArticleBMJ open diabetes research & care2020
Recurrent diabetic ketoacidosis and cognitive function among older adults with type 1 diabetes: findings from the Study of Longevity in Diabetes.
Article in BMJ open diabetes research & care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 24 citations in OpenAlex.
- Cognitive performance declines in older adults with type 1 diabetes: results from 32 years of follow-up in the DCCT and EDIC Study.The lancet. Diabetes & endocrinology · 2021Trial
- Cognitive Function Following Diabetic Ketoacidosis in Children With New-Onset or Previously Diagnosed Type 1 Diabetes.Diabetes care · 2020Trial
- Age of Type 1 Diabetes Onset and Dementia Risk: A Swedish Nationwide, Register-Based Cohort Study.Diabetes, obesity & metabolism · 2026Article
- Biochemical profiles and precipitating factors of diabetic ketoacidosis among type 1 and type 2 diabetes patients: a retrospective analysis from Syria.BMC endocrine disorders · 2026Article
- The Impact of Diabetes on Brain Health in Childhood.Biomedicines · 2026Review
- Life stage transitions for people with type 1 diabetes.The lancet. Diabetes & endocrinology · 2025Review
- Article
- Cognitive decline and diabetes in the clinical setting.Medicine and pharmacy reports · 2025Article
- The Relationship between All-Cause Dementia and Acute Diabetes Complications among American Indian and Alaska Native Peoples.International journal of environmental research and public health · 2024Article
- Advances in risk predictive performance of pre-symptomatic type 1 diabetes via the multiplex Antibody-Detection-by-Agglutination-PCR assay.Frontiers in endocrinology · 2024Article
- Diabetic Ketoacidosis Induces Tau Hyperphosphorylation in Rat Brain.Journal of Alzheimer's disease reports · 2024Article
- Early expression of neuroinflammation in an untreated fatal case of diabetic ketoacidosis.Archives of endocrinology and metabolism · 2024Article
- Triangulating evidence from observational and Mendelian randomization studies of ketone bodies for cognitive performance.BMC medicine · 2023Article
- Corresponding risk factors between cognitive impairment and type 1 diabetes mellitus: A narrative review.Heliyon · 2022Review
- Comparison of cognitive function in older adults with type 1 diabetes, type 2 diabetes, and no diabetes: results from the Study of Longevity in Diabetes (SOLID).BMJ open diabetes research & care · 2022Article
- Lifetime risk and health-care burden of diabetic ketoacidosis: A population-based study.Frontiers in endocrinology · 2022Article
- Discoveries from the study of longstanding type 1 diabetes.Diabetologia · 2021Review
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
Abstract
introductionDiabetic ketoacidosis (DKA) is a serious complication of diabetes. DKA is associated with poorer cognition in children with type 1 diabetes (T1D), but whether this is the case in older adults with T1D is unknown. Given the increasing life expectancy in T1D, understanding the role of DKA on brain health in older adults is crucial. RESEARCH DESIGN AND
methodsWe examined the association of DKA with cognitive function in 714 older adults with T1D from the Study of Longevity in Diabetes. Participants self-reported lifetime exposure to DKA resulting in hospitalization; DKA was categorized into 0 hospitalization, 1 hospitalization or ≥2 hospitalizations (recurrent DKA). Global and domain-specific cognition (language, executive function/psychomotor speed, episodic memory and simple attention) were assessed. The association of DKA with cognitive function was evaluated via linear and logistic regression models.
resultsTwenty-eight percent of participants (mean age=67 years; mean age at diagnosis=28 years; average duration of diabetes=39 years) reported a lifetime history of DKA resulting in hospitalization (18.5% single DKA; 9.7% recurrent DKA). In fully adjusted models, those with recurrent DKA had lower global cognitive function (β=-0.13; 95% CI -0.22 to 0.02) and lower scores on the executive function/psychomotor speed domain (β=-0.34; 95% CI -0.51 to 0.17). Individuals with recurrent DKA were also more likely to have the lowest level of cognitive function on the executive function/psychomotor speed domain (defined as 1.5 SD below the population mean; OR=3.26, 95% CI 1.43 to 7.42).
conclusionsAmong 714 older adults with T1D, recurrent DKA was associated with lower global cognitive function, lower scores on the executive function/psychomotor speed domain and 3.3 times greater risk of having the lowest level of cognitive function in our sample on the executive function/psychomotor speed domain. These findings suggest that recurrent DKA may negatively impact the brain health of older patients with T1D and highlight the importance of DKA prevention.
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