Cognitive function and risks of cardiovascular disease and hypoglycaemia in patients with type 2 diabetes: the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial

Galan, Bastiaan E. de; Zoungas, Sophia; Chalmers, John; Anderson, Craig S.; Dufouil, Carole; Pillai, Avinesh; Cooper, Mark E.; Grobbee, Diederick E.; Hackett, Maree L.; Hamet, Pavel; Heller, Simon; Liu, Lisheng; MacMahon, Stephen; Mancia, Giuseppe; Neal, Bruce; Pan, Chang Yu; Patel, Anushka; Poulter, Neil; Travert, F.; Woodward, Mark

doi:10.1007/s00125-009-1484-7

Cited by 204 publications

(137 citation statements)

References 36 publications

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“…Glycemic targets in patients with "hypoglycemia unawareness" should be relaxed for prolonged periods, pending the potential reversal of the condition [58,59]. In patients with severe coexisting conditions that could interfere with implementation of the management strategy, the goal is prevention of clinically significant glycosuria, water and electrolyte loss, infections, and the development of non ketotic hyperosmolar coma.…”

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confidence: 99%

Classification, Pathophysiology, Diagnosis and Management of Diabetes Mellitus

Baynest¹

2015

J Diabetes Metab

263

250

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Diabetes Mellitus (DM) is a metabolic disorder characterized by the presence of chronic hyperglycemia either immune-mediated (Type 1 diabetes), insulin resistance (Type 2), gestational or others (environment, genetic defects, infections, and certain drugs). According to International Diabetes Federation Report of 2011 an estimated 366 million people had DM, by 2030 this number is estimated to almost around 552 million. There are different approaches to diagnose diabetes among individuals, The 1997 ADA recommendations for diagnosis of DM focus on fasting Plasma Glucose (FPG), while WHO focuses on Oral Glucose Tolerance Test (OGTT). This is importance for regular follow-up of diabetic patients with the health care provider is of great significance in averting any long term complications.

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confidence: 99%

Classification, Pathophysiology, Diagnosis and Management of Diabetes Mellitus

Baynest¹

2015

J Diabetes Metab

263

250

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“…We excluded 87 because the association of baseline cognitive impairment and future stroke was not reported, 6 because most of the participants had a history of stroke at baseline, 3 because they were duplicate reports and 1 because no adjusted estimate was reported. 17 Our final primary analysis included 18 cohort studies [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] (Figure 1). Characteristics of the 18 included studies are shown in Table 1.…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

“…Participants were derived from ordinary cohorts in 14 studies [18][19][20][22][23][24][25]27,[29][30][31][33][34][35] and clinical trials in 4. 21,26,28,32 Most of the studies were from North American or European countries. One was conducted in Taiwan, and 3 were an international collaboration.…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

“…The estimates were similar between the fixed-effects model (RR 1.31, 95% CI 1.26-1.37) and the random-effects model. In the 3 studies with maximal adjustment for potential confounders, baseline cognitive impairment was associated with increased risk of future stroke (RR 1.28, 95% CI 1.18-1.38; random-effects model); 21,25,26 there was no heterogeneity among these studies (I 2 = 0%). When we pooled results from the studies that used a widely adopted definition of cognitive impairment (i.e., Mini-Mental State Examination score < 25 or nearest equivalent), the increased risk of future stroke among patients with cognitive impairment at baseline was still evident (RR 1.64, 95% CI 1.46-1.84; random-effects model) (Figure 3).…”

Section: Primary Analysismentioning

confidence: 98%

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Cognitive impairment and risk of future stroke: a systematic review and meta-analysis

Lee

Saver

Hong

et al. 2014

CMAJ

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C ognitive impairment is a major contributor to disability and dependence worldwide. Globally, stroke is the leading cause of long-term disability among adults and the second leading cause of death.1 The high cumulative risk of dementia or stroke or both conditions has been shown by the Framingham study, 2 and the urgent need to improve knowledge regarding cognition and vascular conditions has been emphasized in a specific meeting providing harmonized standards. 3Beyond their personal tolls, both of these conditions carry substantial social and economic burdens. These conditions also correlate strongly with increasing age. Given the projected substantial rise in the number of older people around the world, prevalence rates of cognitive impairment and stroke are expected to soar over the next several decades, especially in high-income countries. 4,5 Shared pathophysiologic mechanisms seem to exist between cognitive impairment and cerebrovascular disease.6 Indeed, risk factors for stroke (hypertension, hyperlipidemia, diabetes, obesity and physical inactivity) have been shown to play a role in the onset and progression of cognitive impairment, 7 and it is well established that stroke itself increases the risk of future cognitive impairment. 8 However, whether cognitive impairment increases the risk of future stroke remains unclear. Early identification and regular surveillance for cognitive impairment could potentially enable prompt initiation of treatment aimed at not only potentially limiting further deterioration of cognitive function (if mild), but also possibly reducing the risk of future stroke through timely and optimal control of risk factors.Several published studies have assessed the association between cognitive impairment and subsequent risk of stroke, but the results have not been consistent. We performed a systematic review and meta-analysis to determine the qualitative and quantitative association between baseline cognitive impairment and risk of future stroke. Methods Search strategyOur search strategy was based on the recommendations of the Meta-analysis of Observational Studies in Epidemiology group. 9 We searched MEDLINE via PubMed (1966 to November Background: Several studies have assessed the link between cognitive impairment and risk of future stroke, but results have been inconsistent. We conducted a systematic review and meta-analysis of cohort studies to determine the association between cognitive impairment and risk of future stroke.

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“…A different physiopathology involving small-vessel disease might also be involved in patients with clinical symptoms of dementia compatible with AD [37]. Furthermore, the ADVANCE trial stratified participants according to their mini-mental state examination (MMSE) score of 28-30, 24-27 and equal to or below 23 [38]. Comparisons between groups were made with regards to the incidence of cardiovascular events, death and the occurrence of hypoglycemia.…”

Section: Hypoglycemia In the Older Population: Is There A Difference mentioning

confidence: 99%

Optimal Glycemic Control in the Elderly: Where is the Evidence and Who Should Be Targeted?

Tessier

2011

Aging Health

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In the near future, with the continuous increase in life expectancy observed in the population and with the aging of the baby boomers, an increase is expected in the absolute and relative number of the elderly population. With the aging phenomenon, the prevalence of a number of chronic diseases is increasing and requires interventions from different health professionals. Type 2 diabetes mellitus is a very frequent condition in the elderly and is characterized by variable degrees of hyperglycemia while ketosis is exceptional in this condition. The question of who should be offered optimal glycemic control becomes more and more pertinent as the older diabetic population grows but it has to be considered that the consequences of hypoglycemia related to the medications used to lower glycemia are not benign in the older population. Hence, the advantages and disadvantages of tight glycemic control will be reviewed in the light of recent data.

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Cognitive function and risks of cardiovascular disease and hypoglycaemia in patients with type 2 diabetes: the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial

Cited by 204 publications

References 36 publications

Classification, Pathophysiology, Diagnosis and Management of Diabetes Mellitus

Classification, Pathophysiology, Diagnosis and Management of Diabetes Mellitus

Cognitive impairment and risk of future stroke: a systematic review and meta-analysis

Optimal Glycemic Control in the Elderly: Where is the Evidence and Who Should Be Targeted?

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