Progress of Diabetic Severity and Risk of Dementia

Chiu, Wei-Che; Ho, Wen‐Chao; Liao, Ding-Lieh; Lin, Meng‐Hung; Chiu, Chih-Chiang; Su, Yu‐Ping; Chen, Pau‐Chung

doi:10.1210/jc.2015-1677

Cited by 25 publications

(15 citation statements)

References 43 publications

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“…Comparison of associations with anxiety and depression symptoms in type 2 diabetes versus unaffected individuals is an important goal for future studies. We also do not have data on complications of diabetes such as neuropathy and hypoglycemic events that may modify the association of anxiety and depression symptoms with cognitive testing and neuroimaging measures (Chiu, Ho et al 2015). Our cross-sectional analysis is also not able to resolve the direction of causality or potential longitudinal changes for the impact of anxiety and depression on cognitive decline and type 2 diabetes.…”

Section: Discussionmentioning

confidence: 99%

Associations between anxiety and depression symptoms and cognitive testing and neuroimaging in type 2 diabetes

Raffield

Brenes

Cox

et al. 2016

Journal of Diabetes and its Complications

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Structured Abstract Aims Anxiety, depression, accelerated cognitive decline, and increased risk of dementia are observed in individuals with type 2 diabetes. Anxiety and depression may contribute to lower performance on cognitive tests and differences in neuroimaging observed in individuals with type 2 diabetes. Methods These relationships were assessed in 655 European Americans with type 2 diabetes from 504 Diabetes Heart Study families. Participants completed cognitive testing, brain magnetic resonance imaging, the Brief Symptom Inventory Anxiety subscale, and the Center for Epidemiologic Studies Depression-10. Results In analyses adjusted for age, sex, educational attainment, and use of psychotropic medications, individuals with comorbid anxiety and depression symptoms had lower performance on all cognitive testing measures assessed (p≤0.005). Those with both anxiety and depression also had increased white matter lesion volume (p=0.015), decreased gray matter cerebral blood flow (p=4.43 × 10−6), decreased gray matter volume (p=0.002), increased white and gray matter mean diffusivity (p≤0.001), and decreased white matter fractional anisotropy (p=7.79 × 10−4). These associations were somewhat attenuated upon further adjustment for health status related covariates. Conclusions Comorbid anxiety and depression symptoms were associated with cognitive performance and brain structure in a European American cohort with type 2 diabetes.

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Section: Discussionmentioning

confidence: 99%

Associations between anxiety and depression symptoms and cognitive testing and neuroimaging in type 2 diabetes

Raffield

Brenes

Cox

et al. 2016

Journal of Diabetes and its Complications

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“…We set up the FOBT screening design as done for surveillance colonoscopy but used a 2-year time frame. The adapted Diabetes Complications Severity Index (aDCSI) was developed to evaluate the severity of diabetes, which included seven categories of complications with a total score of 0-13 (25,26). We summed all categories of diabetes complications before the index date to calculate the severity index as a baseline aDCSI for each subject.…”

Section: Potential Confoundersmentioning

confidence: 99%

Use of an α-Glucosidase Inhibitor and the Risk of Colorectal Cancer in Patients With Diabetes: A Nationwide, Population-Based Cohort Study

et al. 2015

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OBJECTIVEAcarbose, an a-glucosidase inhibitor, has been shown to have antineoplastic effects on colorectal cancer in biomarker studies. We assessed the association between acarbose use in patients with diabetes and incident colorectal cancer. RESEARCH DESIGN AND METHODSWe conducted a nationwide, population-based study using a large cohort with diabetes in the Taiwan National Health Insurance Research Database. Patients with newly diagnosed diabetes (n = 1,343,484) were enrolled between 1998 and 2010. One control subject not using acarbose was randomly selected for each subject using acarbose after matching for age, sex, diabetes onset, and comorbidities. Cox proportional hazards regression with a competing risks analysis was used to calculate the hazard ratios (HRs) and 95% CIs for the association between acarbose use and incident colorectal cancer for each eligible case-control pair (n = 199,296). RESULTSThere were 1,332 incident cases of colorectal cancer in the cohort with diabetes during the follow-up period of 1,487,136 person-years. The overall incidence rate was 89.6 cases per 100,000 person-years. Patients treated with acarbose had a 27% reduction in the risk of colorectal cancer compared with control subjects. The adjusted HRs were 0.73 (95% CI 0.63-0.83), 0.69 (0.59-0.82), and 0.46 (0.37-0.58) for patients using >0 to <90, 90 to 364, and ‡365 cumulative defined daily doses of acarbose, respectively, compared with subjects who did not use acarbose (P for trend < 0.001). CONCLUSIONSAcarbose use reduced the risk of incident colorectal cancer in patients with diabetes in a dose-dependent manner.Colorectal cancer is one of the most common cancers worldwide (1), causing an estimated 694,000 deaths in 2012 or 9.2% of all cancer-related deaths (2). Fecal occult blood screening and improved treatment in recent decades have reduced the annual global mortality of colorectal cancer (3). The incidence of colorectal cancer varies widely by geographic region and by degree of development. Although

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“…In addition, we evaluated diabetic severity by referring to the Adapted Diabetes Complications Severity Index (aDCSI). 12 The progression of diabetes was defined as a yearly increase in aDCSI score from the date of diagnosis to the end of follow-up; the four progression groups were defined as those with a yearly score increase of <0.51, 0.51-1.00, 1.01-2.00 and >2.0.…”

Section: Variables Of Interestmentioning

confidence: 99%

Risk of allergic conjunctivitis in patients with type 1 diabetes mellitus: a population-based retrospective cohort study

et al. 2017

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ObjectiveIn accordance with the dichotomy between T helper type 1(Th1) and T helper type 2 (Th2) responses, the occurrence of allergic conjunctivitis (AC) and type 1 diabetes mellitus (T1DM) is, in theory, inversely related in the individual. However, recent studies investigating the association between the two diseases are controversial.DesignPopulation-based cohort study.SettingWe used claims data of the National Health Insurance Research Database of Taiwan.ParticipantsWe identified 4160 patients aged 1–30 years with newly diagnosed T1DM and no history of AC at baseline. For each patient with T1DM, four non-T1DM controls (n=16,640) were matched by sex. The mean follow-up time was 6 years.Primary and secondary outcome measuresMultivariate Cox proportional hazards regression analysis was used to evaluate the risk of AC. We additionally evaluated the association between risk of AC and T1DM progression by examining Diabetes Complications Severity Index (aDCSI) changes from the date of diagnosis until the end of follow-up.ResultsThe overall incidence of allergic conjunctivitis (AC) was higher in the type 1 diabetes mellitus (T1DM) cohort than in the control cohort (23.0 vs 13.5 per 1000 person-years, adjusted incidence rate ratio (aIRR): 1.59, 95% CI 1.47 to 1.71). Relative to that in patients with mildly progressive T1DM, the risk of AC increased as the adapted Diabetes Complications Severity Index (aDCSI) increased (aIRR: 1.68, 3.78 and 18.8, with yearly changes in aDCSI score: 0.51 to 1.00, 1.01 to 2.00, and >2.00 vs <0.51, respectively; for trend <0.001).ConclusionPatients with T1DM are at an elevated risk of developing AC; this risk increases with T1DM progression. The T helper type 1/T helper type 2 hypothesis is an overly simplistic explanation for this association.

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Progress of Diabetic Severity and Risk of Dementia

Abstract: The diabetic severity and progression reflected the risk of dementia, and the early change in the aDCSI could predict the risk of dementia in new-onset diabetic patients.

Cited by 25 publications

References 43 publications

Associations between anxiety and depression symptoms and cognitive testing and neuroimaging in type 2 diabetes

Associations between anxiety and depression symptoms and cognitive testing and neuroimaging in type 2 diabetes

Use of an α-Glucosidase Inhibitor and the Risk of Colorectal Cancer in Patients With Diabetes: A Nationwide, Population-Based Cohort Study

Risk of allergic conjunctivitis in patients with type 1 diabetes mellitus: a population-based retrospective cohort study

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