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Review
. 2022 Feb 14;14(1):31.
doi: 10.1186/s13098-022-00799-9.

Association between hypoglycemia and dementia in patients with diabetes: a systematic review and meta-analysis of 1.4 million patients

Lifen Huang  1 , Manlian Zhu  1 , Jie Ji  2   3
Affiliations
Review

Association between hypoglycemia and dementia in patients with diabetes: a systematic review and meta-analysis of 1.4 million patients

Lifen Huang et al. Diabetol Metab Syndr. .

Abstract

Background: Diabetes mellitus (DM) is known to be a risk factor for dementia. However, it is unclear if hypoglycemic events play a role in the risk of dementia. We aimed to systematically review evidence on the risk of dementia in DM patients based on prior hypoglycemic events.

Methods: PubMed, Embase, ScienceDirect, CENTRAL, and Google Scholar databases were searched till 15th November 2021 for cohort studies assessing the risk of dementia based on prior hypoglycemic events in DM patients. Adjusted data were pooled in a random-effects model.

Results: Ten studies with a total of 1,407,643 patients were included. Pooled analysis of all ten studies indicated that hypoglycemic episodes were associated with a statistically significant increase in the risk of dementia in DM patients as compared to those not experiencing hypoglycemic episodes (HR: 1.44 95% CI: 1.26, 1.65 I2 = 89% p < 0.00001). The results did not change on the exclusion of any study. Sub-group analysis based on the study population, type of study, adjustment for glycated hemoglobin, gender, and the number of hypoglycemic episodes also presented similar results.

Conclusions: Evidence from observational studies with a large sample size indicates that DM patients with hypoglycemic episodes are at increased risk of dementia. Anti-hyperglycemic drugs should be adequately tailored in these patients to avoid the risk of dementia.

Keywords: Complication; Dementia; Diabetes; Hypoglycemia.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Study flow chart
Fig. 2
Fig. 2
Meta-analysis of the association between hypoglycemic episodes and risk of dementia in DM patients
Fig. 3
Fig. 3
Funnel plot for the meta-analysis of the association between hypoglycemic episodes and risk of dementia
See this image and copyright information in PMC

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