La hipoglucemia como factor de riesgo para el desarrollo de demencia en pacientes diabéticos: revisión sistemática

Abstract

Recurrent hypoglycemia has been identified as a significant risk factor for the development of dementia in patients with diabetes mellitus, both Type 1 and Type 2. Several studies suggest that hypoglycemic episodes, especially severe ones, can trigger structural alterations in the brain, such as brain volume loss and cortical atrophy, which contribute to cognitive decline. Hypoglycemia can induce direct neuronal damage, affecting key brain areas such as the hippocampus, and can also lead to cerebral hypoperfusion. Objective: This study aims to evaluate the relationship between hypoglycemic episodes and the development of dementia in diabetic patients through a systematic review of the available scientific literature. Methodology: A descriptive systematic literature review was conducted following the PRISMA guidelines. Results: The results indicate that in patients with Type 1 diabetes, repeated exposure to hypoglycemic episodes can double the risk of developing dementia in old age. In Type 2 diabetes, the incidence of dementia increases by 25.4% in those with a history of hypoglycemia. The frequency and severity of hypoglycemic episodes are directly related to an increased risk of cognitive impairment, particularly in older adults. These findings highlight the importance of adequate glucose management in diabetic patients to minimize hypoglycemic episodes and, consequently, prevent the development of dementia, especially in individuals with comorbidities or early signs of cognitive decline. Keywords: hypoglycemia, dementia, cognitive risk, diabetes mellitus