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Hypoglycemia as a risk factor for dementia in diabetes: A systematic review
Monish Konda, Charan Lingutla, Vinay Eruvuri, Shruthi Reddy Gatla, Yethindra Vityala. Advanced Neurology, 2025-10-09
Topic: Risk, prevention and care in population studies
Diabetes is a global health concern associated with complications such as cognitive decline and dementia. This systematic review investigated the risk of hypoglycemia and dementia in patients with diabetes. A comprehensive literature search was conducted using PubMed, Scopus, and Web of Science for cohort studies published between January 1, 2020, and March 15, 2025. Eight studies with over 1.1 million individuals with diabetes, mainly type 2 diabetes (T2D), were included. The selected studies were conducted in various countries and had follow-up periods ranging from 5.9 to 9.14 years. This review demonstrated that hypoglycemic episodes are strongly associated with an increased risk of cognitive decline, including Alzheimer’s disease, vascular dementia, and all-cause dementia. The hazard ratios ranged from 1.25 to 2.80, with multiple episodes significantly increasing the likelihood of dementia. Blood sugar fluctuations, particularly increased hemoglobin A1c levels and variability, heighten the risk of dementia. Sex-based analyses showed that women with T2D faced a higher risk of dementia linked to glycemic factors. The relationship between hypoglycemia and cognitive decline is bidirectional, with cognitive decline affecting diabetes management and leading to hypoglycemia. The findings underscore the importance of maintaining stable blood sugar levels, setting treatment goals, and incorporating cognitive assessments in diabetes care for older adults.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Konda, M., Lingutla, C., Eruvuri, V., Gatla, S. R., & Vityala, Y. (2025). Hypoglycemia as a risk factor for dementia in diabetes: A systematic review. Advanced Neurology. https://doi.org/10.36922/an025270077
Vancouver
Konda M, Lingutla C, Eruvuri V, Gatla SR, Vityala Y. Hypoglycemia as a risk factor for dementia in diabetes: A systematic review. Advanced Neurology. 2025. doi:10.36922/an025270077.
BibTeX
@article{konda2025-4caa182f,
author = {Konda, Monish and Lingutla, Charan and Eruvuri, Vinay and Gatla, Shruthi Reddy and Vityala, Yethindra},
title = {{Hypoglycemia as a risk factor for dementia in diabetes: A systematic review}},
journal = {Advanced Neurology},
year = {2025},
doi = {10.36922/an025270077},
url = {https://doi.org/10.36922/an025270077}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
Key findings
- Diabetes is a global health concern associated with complications such as cognitive decline and dementia.
- This review demonstrated that hypoglycemic episodes are strongly associated with an increased risk of cognitive decline, including Alzheimer’s disease, vascular dementia, and all-cause dementia.
- The hazard ratios ranged from 1.25 to 2.80, with multiple episodes significantly increasing the likelihood of dementia.
- Sex-based analyses showed that women with T2D faced a higher risk of dementia linked to glycemic factors.
Why it matters
This systematic review found that hypoglycemic episodes are strongly associated with an increased risk of cognitive decline and dementia in people with diabetes. It underscores the importance of maintaining stable blood sugar levels, but does not test a treatment or cure for Alzheimer's disease.
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Study details
- Study designsystematic review
- Evidence strengthHigh
How this study scored 46/100
Published in a peer-reviewed journal, and it is a systematic review of all the studies on the question. Scored zero for sample size, effect reported and studied in people because the record does not state it. We have no data on institution's track record, so that was left out: it earned 45 of the 97 points we could judge it on, which is 46 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Advanced Neurology) |
| Journal's citation record | 0 / 4 | Advanced Neurology: journal h-index 7 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A systematic review of all the studies on the question |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | 1 / 7 | Cited 2 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.7 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 2 / 6 | Cited 1.3× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 2 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Yethindra Vityala: h-index 6 (OpenAlex, whole career) |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 0 institution(s) in 0 countries — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Points | 45 / 97 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 45 of the 97 points we could judge it on is 46 out of 100. |
| Total | 46 / 100 | — |
What each of these 20 components measures, and what this score is not →
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