Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
Views 341
Citations 0
Comment & Response
February 2016

Confounders Regarding the Association of Insulin Resistance and Alzheimer Disease

Author Affiliations
  • 1Department of Internal Medicine, Division of Geriatrics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
  • 2Department of Gerontology, Faculty of Medical Sciences, Istanbul University, Istanbul, Turkey

Copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Neurol. 2016;73(2):239-240. doi:10.1001/jamaneurol.2015.3983

To the Editor We read the article by Willette et al1 with interest. The findings of this study are important because insulin resistance is a growing health problem, and measures to decrease the incidence of Alzheimer disease (AD) are urgently needed. However, we have some comments on this well-designed and well-performed study.

First, checking fasting glucose levels only once may be insufficient to diagnose or exclude diabetes mellitus (DM). For an accurate diagnosis of DM, fasting glucose levels of 126 mg/dL or greater on 2 occasions (to convert to millimoles per liter, multiply by 0.0555), a glycated hemoglobin level of 6.5% or greater (to convert to proportion of total hemoglobin, multiply by 0.01), a random blood glucose level of 200 mg/dL or greater with accompanying symptoms, or a second-hour blood glucose level at 75-g oral glucose tolerance test of 200 mg/dL or greater are needed. Older adults with DM, especially, may have normal fasting blood glucose levels.2 To draw more accurate conclusions regarding the association of insulin resistance and AD, measuring postprandial glucose levels and/or glycated hemoglobin levels would prove beneficial.

First Page Preview View Large
First page PDF preview
First page PDF preview