Huang Lifen, Zhu Manlian, Ji Jie
Department of Geriatrics, Lishui Second People's Hospital, Lishui, China.
Department of Rehabilitation, Lishui Second People's Hospital, Fifth floor, Rehabilitation Building, 69 Huan North Road, Lishui, China.
Diabetol Metab Syndr. 2022 Feb 14;14(1):31. doi: 10.1186/s13098-022-00799-9.
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.
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.
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 I= 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.
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.
糖尿病（DM）是已知的痴呆症风险因素。然而，尚不清楚低血糖事件是否在痴呆症风险中起作用。我们旨在系统回顾基于既往低血糖事件的糖尿病患者痴呆症风险的证据。
检索了PubMed、Embase、ScienceDirect、CENTRAL和谷歌学术数据库，直至2021年11月15日，以查找评估基于糖尿病患者既往低血糖事件的痴呆症风险的队列研究。在随机效应模型中汇总调整后的数据。
纳入了10项研究，共1407643名患者。对所有10项研究的汇总分析表明，与未经历低血糖发作的患者相比，低血糖发作与糖尿病患者痴呆症风险的统计学显著增加相关（HR：1.44，95%CI：1.26，1.65，I = 89%，p < 0.00001）。排除任何一项研究后结果不变。基于研究人群、研究类型、糖化血红蛋白调整、性别和低血糖发作次数的亚组分析也得出了类似结果。
来自大样本观察性研究的证据表明，有低血糖发作的糖尿病患者患痴呆症的风险增加。应在这些患者中适当调整降糖药物，以避免痴呆症风险。
