Metformin displayed lowest risk for dementia across diverse antidiabetics, while α-glucosidase inhibitors had highest risk
By Elana Gotkine HealthDay Reporter
MONDAY, July 15, 2024 (HealthDay News) — Compared with other antidiabetic classes, metformin and sodium glucose co-transporter-2 inhibitors (SGLT2is) exhibit significantly lower dementia risk, according to a review published online May 3 in the American Journal of Preventive Medicine.
Yongjun Sunwoo, from the College of Pharmacy at Kyung Hee University in Seoul, South Korea, and colleagues conducted a systematic review and meta-analysis to examine the risk for dementia and Alzheimer disease (AD) associated with antidiabetic medication classes. Data were included from 16 studies with 1,565,245 patients.
The researchers found that the risks for dementia and AD were significantly lower with metformin and SGLT2is. Across diverse antidiabetics, metformin exhibited the lowest risk for dementia, while the highest risk was seen for α-glucosidase inhibitors. Across second-line antidiabetics, SGLT2is exhibited the lowest dementia risk. In the elderly (aged 75 years and older), a significantly higher dementia risk was seen with dipeptidyl peptidase-4 inhibitors, metformin, sulfonylureas, and thiazolidinediones compared with SGLT2is. Regardless of diabetic complication status or baseline hemoglobin A1c, dementia risk associated with metformin was substantially lower.
“Optimal glycemic control with appropriate pharmacotherapy along with endorsement of routine cognitive status monitoring in diabetic patients are imperative to enhance prognoses associated with diabetes mellitus-related cognitive impairment,” the authors write.
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