Glucose levels and dementia

The study published in the New England Journal of Medicine August 8, “Glucose Levels and Risk of Dementia,” has received an unusual amount of coverage in the popular press, and in fact it is a bit of a bombshell. Its authors’ rather laconic conclusion—“Our results suggest that higher glucose levels may be a risk factor for dementia, even among persons without diabetes”—has potentially far-reaching clinical implications. Lead author Paul Crane, MD, MPH, expanded on that as follows:  “We found a steadily increasing risk….There’s no threshold, no place where the risk doesn’t go up any further or down any further.” Down the road, what might that mean for testing volume, and how else might it affect the clinical lab?