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Impact of Type 2 Diabetes and Glycated Hemoglobin Levels Within the Recommended Target Range on Mortality in Older Adults With Cognitive Impairment Receiving Care at a Memory Clinic: NCGG-STORIES

医学 糖化血红素 糖尿病 2型糖尿病 危险系数 低血糖 老年学 比例危险模型 老年病科 队列 回顾性队列研究 内科学 精神科 置信区间 内分泌学
作者
Taiki Sugimoto,Takashi Sakurai,Kazuaki Uchida,Yujiro Kuroda,Harukuni Tokuda,Tomoko Omura,Taiji Noguchi,Ayane Komatsu,Takeshi Nakagawa,Kosuke Fujita,Nanae Matsumoto,Rei Ono,Paul K. Crane,Tami Saito
出处
期刊:Diabetes Care [American Diabetes Association]
标识
DOI:10.2337/dc23-2324
摘要

To determine the impact of type 2 diabetes and glycated hemoglobin (HbA1c) levels within the recommended target range according to the Japan Diabetes Society/Japan Geriatrics Society Joint Committee on mortality in older adults with cognitive impairment.This retrospective cohort study included 1,528 and 468 patients aged ≥65 years without and with type 2 diabetes, respectively, who were visiting a memory clinic. The 468 patients with type 2 diabetes were divided into three groups (within, above, and below the target range) based on their HbA1c levels, cognitive function, ability to perform activities of daily living, and medications associated with a high risk of hypoglycemia. The impact of diabetes and HbA1c levels on mortality was evaluated using Cox proportional hazards models.Over a median follow-up period of 3.8 years, 353 patients (17.7%) died. Compared with individuals without type 2 diabetes, HbA1c levels above (hazard ratio [HR] 1.70, 95% CI 1.08-2.69) and below (HR 2.15, 95% CI 1.33-3.48) the target range were associated with a higher risk of death; however, HbA1c levels within the target range were not (HR 1.02, 95% CI 0.77-1.36).HbA1c levels above and below the target range were associated with a higher risk of mortality, whereas patients with HbA1c levels within the target range did not exhibit a higher risk of mortality than individuals without type 2 diabetes. These results provide empirical support for the current target ranges among older adults with cognitive impairment.
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