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Cohort study
Cognitive impairment is a major risk factor for serious hypoglycaemia; public health intervention is warranted
  1. Denise G Feil1,2,
  2. Leonard M Pogach3,4
  1. 1 VA Greater Los Angeles Center of Innovation Center of Excellence, Health Services Research and Development, Sepulveda, CA, USA
  2. 2 Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
  3. 3 Department of Veterans Affairs, New Jersey Healthcare System, East Orange, New Jersey, USA
  4. 4 Rutgers University-NJMS, Newark, New Jersey, USA
  1. Correspondence to: Dr Denise G Feil, Division of Geriatric Psychiatry, West Los Angeles VA Healthcare Center—11301 Wilshire Blvd., 116-AE Los Angeles, CA 90073, USA; denise.feil{at}

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Severe hypoglycaemia in persons with diabetes mellitus (DM) has received recognition as a major public health problem in recent years.1 Recently the US Department of Health and Human Services proposed a National Action Plan2 for hypoglycaemic safety that emphasises known risk factors for severe hypoglycaemia, including cognitive impairment (CogI) and dementia (D). Yaffe and colleagues add to the epidemiological evidence defining this at-risk population.


The authors used a 12-year longitudinal population-based study of 783 older, multiracial, multiethnic adults with DM to evaluate whether CogI or D increases the risk of developing a severe hypoglycaemic event and whether prior hypoglycaemia …

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  • Competing interests LMP is the co-chair of the Health and Human Services Adverse Drug Event Hypoglycemic Safety Federal Interagency Workgroup