Repeated episodes of hypoglycaemia have been associated with a twofold increase in dementia risk (
Mehta et al., 2017), with the risk rising proportionally with the number of episodes. Notably, T2DM patients with dementia and impaired self-management abilities exhibit a threefold increased risk of severe hypoglycaemic events (
Yaffe et al., 2013). This bidirectional relationship was confirmed by the Edinburgh Type 2 Diabetes Study, which reported that a history of hypoglycaemia was linked to accelerated cognitive decline, while cognitive impairment increased susceptibility to severe hypoglycaemia (
Feinkohl et al., 2014). A population-based retrospective cohort study of 831 patients experiencing at least one hypoglycaemic event found elevated risks for both dementia and Alzheimer’s disease, with hazard ratios of 1.26 and 1.28, respectively (
Kim et al., 2019). More recently, it was shown that 23 % of patients with a history of hypoglycaemia went on to develop dementia—especially Alzheimer’s disease—compared to only 7 % among those without such events. The risk increased from 1.5 for one hypoglycaemic episode to 1.8 for two or more (
Han et al., 2022).