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SGLT-2 Inhibitors May Cut Dementia Risk in Patients With Diabetes

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Findings show greater effect with longer treatment, compared with dipeptidyl peptidase-4 inhibitors

By Lori Solomon HealthDay Reporter

TUESDAY, Sept. 3, 2024 (HealthDay News) — Sodium-glucose cotransporter-2 (SGLT-2) inhibitors may prevent dementia in middle-aged adults with diabetes, according to a study published online Aug. 28 in The BMJ.

Anna Shin, from Seoul National University Bundang Hospital in South Korea, and colleagues compared the risk for dementia associated with SGLT-2 inhibitors versus dipeptidyl peptidase-4 (DPP-4) inhibitors in adults (aged 40 to 69 years) with type 2 diabetes. The analysis included 110,885 propensity-matched pairs followed for a mean of 670 days.

The researchers found that the incidence rate for dementia was 0.22 per 100 person-years in initiators of SGLT-2 inhibitors and 0.35 per 100 person-years in initiators of DPP-4 inhibitors (hazard ratios: 0.65 for dementia, 0.54 for dementia requiring drugs, 0.61 for Alzheimer disease, and 0.48 for vascular dementia). Findings persisted regardless of dementia type and across subgroups categorized by age, sex, concomitant use of metformin, and baseline cardiovascular risk. When adjusting for residual confounding (measured by cataract surgery), the risk for dementia remained lower (hazard ratio, 0.70). The association was stronger for treatment of more than two years (hazard ratio, 0.57).

“Highly consistent results over a range of secondary and sensitivity analyses supported the robustness of our study findings,” the authors write.

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