Oral Diabetes Medication and Risk of Dementia in Elderly Patients with Type 2 Diabetes

Diabetes Research and Clinical Practice
11 Jul, 2019 ,

Ju Young Kim et al conducted a population-based cohort study to investigate the impact of oral diabetes medication on the risk of dementia in the elderly. Participants in the study included subjects aged 60 years or older with and without type 2 diabetes. New-onset type 2 diabetes patients were further divided into oral diabetes medication and no-medication groups. The three-drug combination of sulfonylurea, metformin, and DPP4 inhibitor was associated with a 63% reduced dementia risk vs the sulfonylurea monotherapy group. Overall, in elderly patients with type 2 diabetes, the use of oral diabetes medication significantly reduced the risk of dementia.

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Abstract

Aim

To examine the effect of oral diabetes medication on the risk of dementia in an elderly cohort with type 2 diabetes.

Methods

This was a population-based cohort study using the Korean National Health Insurance claims data from 2002 to 2013. Elderly subjects (60 years of age or older) with and without type 2 diabetes were included; patients with new-onset type 2 diabetes were further divided into the oral diabetes medication group and no-medication group.

Results

Among 278,290 patients with type 2 diabetes, 56,587 developed dementia (20.3%) over 11 years of follow-up. Type 2 diabetes was associated with a 1.69-fold increased risk of dementia (95% CI 1.66–1.72). Among patients with newly diagnosed type 2 diabetes, the risk of dementia was lower in the oral diabetes medication group than in the no-medication group (adjusted hazard ratio [aHR], 0.79; 95% CI 0.77–0.81). Lower risk of dementia was particularly noticeable in all of the combination therapy groups and especially lower in the combination therapy group treated with dipeptidyl peptidase 4 inhibitor (aHR 0.48, 95% CI 0.45–0.51,).

Conclusion

Overall, the use of oral diabetes medication in type 2 diabetes patients significantly decreased the risk of dementia.