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Diabetics Warned About Hypoglycemia, Dementia

The World Health Organization estimates at least 180 million people have diabetes, and twice that many will be diagnosed by the year 2030. Controlling blood sugar through diet and medication is critically important. Now studies show that low blood sugar can also have serious consequences beyond diabetes.

Frank Gold is part of the vast majority of diabetics around the world diagnosed with Type Two diabetes. Most are older adults.

Health experts say Type Two occurs when the body does not effectively use the insulin it produces.

It is often the result of obesity and lack of exercise.

Gold, a diabetic for more than two decades, closely monitors his blood sugar level with medicine and insulin. But recently, based on his doctor's advice, he revised the acceptable range of his blood sugar level. "The procedure [has] changed to allow me to have a higher blood sugar," Gold explains.

Gold is trying to avoid an episode of hypoglycemia that might send him to the hospital.

"Hypoglycemia is when your blood sugar falls below average levels and in people with Type Two diabetes," Rachel Whitmer said. "This can happen as a result of either taking too much insulin or overuse of certain oral medications."

Whitmer is a researcher with the Kaiser Permanente health care system.

She and her colleagues concluded that each time patients had hypoglycemic episodes of dizziness, disorientation, fainting or seizures severe enough to require hospitalization, their chances of dementia [a progressive decline in cognitive function] increased later in life.

"Even when we also considered hypoglycemic episodes that occurred in mid-life, when the patients were in their early 50s, there still was a significant association between those episodes and an elevated risk of dementia in late life," Whitmer said.

The Kaiser Permanente researchers analyzed medical records of more than 16,000 patients with Type Two diabetes. The average age was 65.

Patients with one hypoglycemic episode had a 26 percent risk of dementia, those with two episodes were at 80 percent risk, and three or more episodes put patients at double the risk.

"It really adds to the evidence base out there that perhaps very low glycemic targets might not be the best way to go in elderly patients with -- with Type Two," Whitmer added.

The findings were published in the Journal of the American Medical Association, which has devoted the entire issue to the latest developments in diabetes research.