People aged 60 years or older receiving thiazolidinedione monotherapy for type 2 diabetes may have a lower risk for dementia than those taking metformin monotherapy, an observational study suggests.

Study results suggest that telmisartan use in people with concomitant type 2 diabetes and hypertension is associated with a lower incidence of dementia and ischemic stroke compared with the use of other angiotensin receptor blockers.

Research published in JAMA suggests the risk for dementia increases with younger age at type 2 diabetes diagnosis, with the risk further increased in people who have a stroke.

Among people with type 2 diabetes, those with hypoglycemic events, microvascular complications, or high or unstable glycated hemoglobin levels might have an increased risk for dementia, researchers report.

The onset of dementia in people with type 2 diabetes may be foreshadowed by elevated levels of some vascular risk factors 1 to 2 decades beforehand, say researchers.

The increased risk for dementia associated with type 2 diabetes is strongest for vascular dementia, researchers have reported at the virtual 56th EASD Annual Meeting.

A Mendelian randomization analysis supports a causal role of high blood glucose in unspecified dementia, but not in Alzheimer’s disease or vascular dementia.

Diabetologist Amar Puttanna addresses growing concerns about the rise of dementia in diabetes care and highlights where guidelines, research efforts, and management options are needed to tackle this comorbidity.

Lacy ME et al. Diabetes Care 2018: dc180073. doi: 10.2337/dc18-0073

Research finds that diabetes patients develop dementia earlier than other people, but that they also die younger, so do not live with dementia for any greater time.

Deintensifying diabetes treatment does not increase the risk for short-term adverse outcomes in male nursing home residents with limited life expectancy or advanced dementia, say researchers.

Two studies, including a long-term DCCT analysis, highlight the importance of severe hypoglycemia in the risk for people with type 1 diabetes developing dementia.

Results from an observational study suggest that the use of metformin in older patients with type 2 diabetes is associated with a reduced decline in both global cognition and executive function, and a decreased risk for dementia.

Researchers have identified localized white matter microstructural damage in people with prediabetes and widespread abnormalities in those with type 2 diabetes.

These are people who have chronic kidney disease, an organ transplant, dementia, or an eating disorder, as well as those who are immunodeficient, younger than 18 years or old and/or frail, pregnant or breastfeeding, or undergoing cancer treatment.

Among individual comorbidities, cancer (OR=1.87), dementia or Alzheimer's disease (OR=1.73), peripheral vascular disease (OR=1.59), paralysis, hemiplegia, or paraplegia (OR=1.51), hepatitis (OR=1.50), congestive heart failure (OR=1.47), cardiac arrhythmia (OR=1.29), liver/gallbladder/pancreatic disease (OR=1.26), and hypertension (OR=1.19) were each independently associated with a significantly increased hypoglycemia risk.

Moreover, although the excess mortality in the diabetes group declined over the study period for deaths due to vascular causes, it increased for dementia, diabetes-associated cancers, other cancers, and respiratory diseases.

A selection of topical peer-reviewed articles from the Adis journals, curated by the editors.