Diabetic ketoacidosis further increases risk of Alzheimer’s disease in patients with type 2 diabetes

Abstract Aim Diabetes mellitus (DM) is a known risk factor for dementia. It is unclear whether diabetic ketoacidosis (DKA) further increases the risk of dementia in patients with type 2 DM. Methods This retrospective nationwide population-based cohort study was conducted using Taiwan’s National Health Insurance database. We extracted claims data for 4451 patients with type 2 diabetes and DKA and 8902 diabetic controls matched for age, gender, diabetes complication severity index, frequency of clinic visits and baseline comorbidities between 2000 and 2002. Patients with type 1 diabetes or prior hypoglycemia before index date were excluded. All patients were tracked until new dementia diagnosis, death, or end of 2011. Results Of the 4451 DKA patients, 211 (4.7%) and 305 (3.4%) of the 8902 diabetic controls were diagnosed as having dementia during the follow-up period. The incidence rate ratio (IRR) for dementia was 1.62 (95% CI 1.35–1.93; P  Conclusion Type 2 diabetes patients with DKA are at increased risk of Alzheimer’s dementia but not non-Alzheimer dementia.