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 A1c 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 A1c levels calculated from the 14 days of AGP data significantly correlated with the HbA1c 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 HbA1c values. Geriatr Gerontol Int 2019; 19: 282-286.

Cerebrospinal fluid analysis in individuals with diabetes-related dementia.

•CSF P-tau and Aß42 show normal levels in diabetes-related dementia.•Diabetes-related dementia may have a different underlying pathology from AD.•CSF analysis is useful for the differentiation of diabetes-related dementia from AD.