Antidiabetic medication and risk of dementia in patients with type 2 diabetes: a nested case control study

TY - JOUR

T1 - Antidiabetic medication and risk of dementia in patients with type 2 diabetes

T2 - a nested case control study

AU - Wium-Andersen, Ida Kim

AU - Osler, Merete

AU - Jøgensen, Martin Balslev

AU - Rungby, Jørgen

AU - Wium-Andersen, Marie Kim

PY - 2019

Y1 - 2019

N2 - Objective: Diabetes is a risk factor for dementia, but whether antidiabet ic medication decreases the risk is unclear. We examined the association between antidiabetic medication and de mentia. Design: We performed a nested case-control study within a cohort of all 176 250 patients registered with type 2 diabetes in the Danish National Diabetes Register between 1995 and 2012. This population was followed for dementia diagnosis or anti-dementia medication use until May 2018. Using risk-set sampling, each dementia case (n = 11 619) was matched on follow-up time and calender year of dementia with four contr ols randomly selected among cohort members without dementia (n = 46 476). Ever use and mean daily defined dose of antidiabetic medication was categorized in types (insulin, metformin, sulfonylurea and glinides combined, glitazone, dipeptidyl peptidase 4 (DPP4) inhibitors, glucagonlike peptide 1 (GLP1) analogs, sodium-glucose transport protein 2 (SGLT2) inhibitors and acarbose). Methods: Conditional logistic regression models were fitted to calculate odds ratios (ORs) for dementia associated with antidiabetic medication use, adjusting for potential confounders. Results: Use of metformin, DPP4 inhibitors, GLP1 analogs, and SGLT2 inh ibitors were associated with lower odds of dementia after multible adjustments (ORs of 0.94 (95% confidence interval (CI): 0.89-0.99), 0.80 (95% CI 0.74-0.88), 0.58 (95% CI: 0.50-0.67), and 0.58 (95% CI: 0.42-0.81), respect ively), with a gradual decrease in odds of dementia for each increase in daily defined dose. Analyses of the most freque nt treatment regimes did not show any synergistic effects of combined treatment. Conclusion: Use of metformin, DPP4 inhibitors, GLP1 analogs and SGLT2 inhi bitors was associated with lower risk of dementia in patients with diabetes.

AB - Objective: Diabetes is a risk factor for dementia, but whether antidiabet ic medication decreases the risk is unclear. We examined the association between antidiabetic medication and de mentia. Design: We performed a nested case-control study within a cohort of all 176 250 patients registered with type 2 diabetes in the Danish National Diabetes Register between 1995 and 2012. This population was followed for dementia diagnosis or anti-dementia medication use until May 2018. Using risk-set sampling, each dementia case (n = 11 619) was matched on follow-up time and calender year of dementia with four contr ols randomly selected among cohort members without dementia (n = 46 476). Ever use and mean daily defined dose of antidiabetic medication was categorized in types (insulin, metformin, sulfonylurea and glinides combined, glitazone, dipeptidyl peptidase 4 (DPP4) inhibitors, glucagonlike peptide 1 (GLP1) analogs, sodium-glucose transport protein 2 (SGLT2) inhibitors and acarbose). Methods: Conditional logistic regression models were fitted to calculate odds ratios (ORs) for dementia associated with antidiabetic medication use, adjusting for potential confounders. Results: Use of metformin, DPP4 inhibitors, GLP1 analogs, and SGLT2 inh ibitors were associated with lower odds of dementia after multible adjustments (ORs of 0.94 (95% confidence interval (CI): 0.89-0.99), 0.80 (95% CI 0.74-0.88), 0.58 (95% CI: 0.50-0.67), and 0.58 (95% CI: 0.42-0.81), respect ively), with a gradual decrease in odds of dementia for each increase in daily defined dose. Analyses of the most freque nt treatment regimes did not show any synergistic effects of combined treatment. Conclusion: Use of metformin, DPP4 inhibitors, GLP1 analogs and SGLT2 inhi bitors was associated with lower risk of dementia in patients with diabetes.

U2 - 10.1530/eje-19-0259

DO - 10.1530/eje-19-0259

M3 - Journal article

C2 - 31437816

SN - 0804-4643

VL - 181

SP - 499

EP - 507

JO - European Journal of Endocrinology

JF - European Journal of Endocrinology

IS - 5

ER -