Diabetic Patients with Dementia May Benefit from Additional Diabetes Management Support

September 13, 2022

September 13, 2022
Contact: Ellen Mullally

Diabetes self-care becomes increasingly challenging as cognition declines. A new study in the September issue of JAMDA highlighted the important differences in monitoring, management, and control of diabetes in people with dementia. The authors found that the effects of frailty and the extent of cognitive impairment on the ability to self-manage diabetes, as well as on glycemic control, may need to be considered in treatment guidelines and by primary care.

In The Impact of Dementia on Diabetes Control: An Evaluation of HbA1c Trajectories and Care Outcomes in Linked Primary and Specialist Care Data, the authors compared HbA1c trajectories, markers of diabetes-related management, severity of dementia diagnosis, and healthcare usage. They found that, despite individuals with dementia having increased healthcare services around the dementia diagnosis, they were less likely to have had routine diabetes-related management.

At the same time, patients with dementia had a higher prevalence of macrovascular complications and diabetes foot morbidity at diagnosis with dementia and a higher mortality risk than individuals without dementia. These connections were more marked in patients with moderate to severe dementia.

Overall, the researchers found that individuals with dementia had a longer diabetes duration and a higher mean HbA1c at index date than those without dementia. HbA1c levels showed a greater increase over time in those with mild versus no dementia, but a decrease in those with moderate to severe versus no dementia.

The authors said, “Tailoring diabetes management and adapting diabetes care-related indicators in the primary care setting to account for the effects of frailty and the extent of cognitive impairment may help to improve clinical outcomes, quality, access, and efficiency of care in this vulnerable population.”

This article was conducted by researchers at the Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, UK; School of Population Health and Environmental Sciences, King’s College, London, UK; Research Statistics, GSK R&D, London, UK; and South London and Maudsley NHS Foundation Trust, London, UK.

Get more information on the findings above and more details about the study. To contact the researchers or JAMDA editor for an interview, please email emullally@paltc.org.





JAMDA is the official journal of AMDA – The Society for Post-Acute and Long-Term Care Medicine. JAMDA publishes peer-reviewed articles including original studies, reviews, clinical experience articles, case reports, and more, on all topics more important to post-acute and long-term care medicine. Visit www.jamda.com for more information.

About AMDA – The Society for Post-Acute and Long-Term Care Medicine
AMDA – The Society for Post-Acute and Long-Term Care Medicine is the only medical specialty society representing the community of over 50,000 medical directors, physicians, nurse practitioners, physician assistants, and other practitioners working in the various post-acute and long-term care (PALTC) settings. Dedicated to defining and improving quality, we advance our mission through timely professional development, evidence-based clinical guidance, and tireless advocacy on behalf of members, patients, families, and staff. Visit www.paltc.org for more information.