Diabetic patients who are severely obese have more likelihood of developing dementia

The likelihood of mild cognitive impairment (MCI) probable dementia (PD) varied by type 2 diabetes (T2D) subgroups in people with T2D who were overweight or obese was shown to be increased, says an article published in The Journal of Clinical Endocrinology & Metabolism.

This study was undertaken by Michael Bancks and colleagues to determine (1) if particular type 2 diabetes subgroups are linked with moderate cognitive impairment or probable dementia, and (2) whether T2D subgroups altered the connection of the Action for Health in Diabetes (Look AHEAD) multidomain intensive lifestyle intervention (ILI) with mild cognitive impairment/probable dementia.

3760 Look AHEAD patients with T2D and overweight or obesity were randomly allocated to 10 years of ILI or diabetes support and education, according to the study. To describe diabetes subgroups at randomization, K-means clustering algorithms were employed using data on age of diabetes diagnosis, body mass index, waist circumference, and glycated hemoglobin (HbA1c). Prevalence of MCI/PD was centrally judged 10-13 years after randomization based on standardized cognitive tests and other health information. Marginal probabilities for prevalent MCI/PD among T2D subgroups were computed after adjusting for possible confounders and attrition, and it was evaluated if ILI affected any correlations.

The key findings of this study were:

1.There were four separate T2D subgroups found, with older age at diabetes onset (43% of the sample), high HbA1c (13%), severe obesity (23%), and younger age at onset (22%).

2.Unadjusted MCI/PD prevalence (314 cases, 8.4%) varied by T2D subgroup (older onset = 10.5%, severe obesity = 9.0%, high HbA1c = 7.9%, and younger onset = 4.0%).

3.The adjusted likelihood for MCI/PD within a T2D subgroup was highest in the severe obesity subgroup and lowest in the younger onset subgroup, but did not change by ILI arm (interaction p-value = 0.84).

In conclusion, severe obesity may be connected with an elevated risk of mild cognitive impairment/probable dementia in people with type 2 diabetes.

Reference:

Bancks, M. P., Lovato, J., Balasubramanyam, A., Coday, M., Johnson, K. C., Munshi, M., Rebello, C., Wagenknecht, L. E., & Espeland, M. A. (2022). Association of type 2 diabetes subgroups with cognitive status without modification from lifestyle intervention. In The Journal of Clinical Endocrinology & Metabolism. The Endocrine Society. https://doi.org/10.1210/clinem/dgac706