Researchers at the University of Tucson, Arizona, studied the medical records of nearly 560,000 American veterans over the age of 60 with type 2 diabetes. Their goal: to test whether anti-diabetes drugs are associated with a lower risk of dementia. For these researchers, anti-diabetic drugs can effectively prevent dementia in high-risk people with mild to moderate type 2 diabetes, because type 2 diabetes and dementia share several physiological patterns.
They therefore decided to compare the risk of onset of dementia in diabetic patients treated with sulfonylureas (SU) or thiazolidinediones (TZD) with patients treated with metformin (MET). They included in their study patients aged at least 60 who received a first prescription for metformin, a sulfonylurea (tolbutamide, glimepiride, glipizide or glyburide) or a TZD (rosiglitazone or pioglitazone) between January 2001 and December 2017. The evolution of their state of health was followed for an average of almost 8 years.
Lower risk of dementia and Alzheimer’s disease with thiazolidinediones
Their initial findings were published in the British medical journal. They specify that after at least 1 year of drug treatment, the use of a thiazolidinedione (TZD) alone is associated with a 22% lower risk of dementia whatever the cause, compared to the use of metformin alone. And more specifically, this class of drug decreases the risk of vascular dementia by 57% and Alzheimer’s disease by 11%. These drugs also appear to be more protective in overweight or obese patients.
However, the researchers moderate the results by recalling that this is an observational study and that certain information concerning, in particular, kidney function and genetic factors are absent from the study. But they say their study “may help inform drug selection for patients with type 2 diabetes at high risk of dementia.”
Source : Use of oral diabetes medications and the risk of incident dementia in US veterans aged ≥60 years with type 2 diabetesBMJ Journals, November 2022
