The Relationship between All-Cause Dementia and Acute Diabetes Complications among American Indian and Alaska Native Peoples

Xiaoyi Niu, Jenny Chang, Maria M. Corrada, Ann Bullock, Blythe Winchester, Spero M. Manson, Joan O’Connell and Luohua Jiang ()
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Xiaoyi Niu: Department of Epidemiology & Biostatistics, University of California Irvine, Irvine, CA 92697, USA
Jenny Chang: Department of Medicine, University of California Irvine, Irvine, CA 92697, USA
Maria M. Corrada: Department of Epidemiology & Biostatistics, University of California Irvine, Irvine, CA 92697, USA
Ann Bullock: Formerly with the Division of Diabetes Treatment and Prevention, Indian Health Service, Rockville, MD 20857, USA
Blythe Winchester: Cherokee Indian Hospital, Cherokee, NC 28719, USA
Spero M. Manson: Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
Joan O’Connell: Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
Luohua Jiang: Department of Epidemiology & Biostatistics, University of California Irvine, Irvine, CA 92697, USA

IJERPH, 2024, vol. 21, issue 4, 1-13

Abstract: Background: American Indian and Alaska Native people (AI/AN) bear a disproportionate burden of diabetes. Growing evidence shows significant associations between several acute diabetes complications and dementia among diabetes patients. However, little is known about these relationships among AI/AN adults. Here, we aim to investigate these associations among AI/AN adults. Methods: This cross-sectional study extracted data from the Indian Health Service’s (IHS) National Data Warehouse and related administrative databases. A total of 29,337 IHS actual users with diabetes who were 45+ years old during fiscal year 2013 were included. All-cause dementia and diabetes complications were identified using ICD-9 diagnostic codes. Negative binomial regression models were used to evaluate the associations of interest. Results: Nearly 3% of AI/AN diabetes patients had a dementia diagnosis. After controlling for covariates, dementia was associated with a 94% higher rate of severe hypoglycemia (Incidence Rate Ratio [IRR = 1.94, 95% CI:1.50–2.51), 52% higher rate of severe hyperglycemia (IRR = 1.52, 95% CI, 1.11–2.08), and 92% higher rate of any acute complication (IRR = 1.92, 95% CI:1.53–2.41). Conclusions: AI/AN diabetes patients with dementia suffered from considerably higher rates of acute diabetes complications than their counterparts without dementia. The clinical management of patients with comorbid diabetes and dementia is particularly challenging and may require individualized treatment approaches.

Keywords: Alzheimer’s disease; American Indian or Alaska Native; dementia; diabetic ketoacidosis; hypoglycemia; hyperglycemia (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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