Ambulatory glucose profile in diabetes-related dementia.

AIM

Diabetes-related dementia (DrD), a dementia subgroup associated with specific diabetes mellitus (DM)-related metabolic abnormalities rather than Alzheimer's disease (AD) pathology or cerebrovascular disease, is characterized by less well-controlled glycemia. We investigated the glucose level, variability and stability, and risk of hypoglycemia in DrD to determine characteristic ambulatory glucose profiles (AGP).

METHODS

We obtained AGP for 14 days of 40 patients with AD associated with DM and 19 patients with DrD using a novel sensor-based flash glucose monitoring system (FreeStyle Libre Pro).

RESULTS

Despite similar mean glucose and estimated A values, the DrD group showed significantly greater glucose variability and higher percentage of time spent in hypoglycemia than the AD associated with DM group. Glucose level and variability correlated significantly and negatively with Mini-Mental State Examination in DrD, but not in AD associated with DM The estimated A levels calculated from the 14 days of AGP data significantly correlated with the HbA levels measured within 2 months of the insertion of the sensor.

CONCLUSIONS

DrD has a distinctively different AGP from that of AD associated with DM. Glucose variability and hypoglycemia are more involved in the pathophysiology of DrD than in that of AD associated with DM. The AGP analysis using the flash glucose monitoring system might provide useful information undetected by HbA values. Geriatr Gerontol Int 2019; 19: 282-286.