Two newer classes of second-line hypoglycemic drugs, glucagon-like peptide-1 (GLP-1) agonists and dipeptidyl peptidase-4 (DPP-4) inhibitors, have gained popularity among patients with type 2 diabetes.
Some research suggests that GLP-1 agonists are linked to a lower risk of cognitive impairment and dementia compared to placebo in patients with type 2 diabetes. Other trials indicate that DPP-4 inhibitors do not produce significantly different cognitive outcomes compared to placebo or sulfonylurea in patients with type 2 diabetes.
There is limited evidence on how GLP-1 agonists and DPP-4 inhibitors compare to each other or sulfonylureas, which are the most commonly used second-line antihyperglycemic class in dementia patients with type 2 diabetes.
In the current study, researchers analyzed Swedish healthcare data to compare the effectiveness of these drug classes in affecting dementia risk in older individuals with type 2 diabetes. They included 88, 381 participants in their analysis, including 12, 351 who had prescriptions for GLP-1 agonists, 43, 850 who had prescriptions for DPP-4 inhibitors and 32, 216 who had prescriptions for sulfonylureas. They were followed for an average of 4.3 years.
Altogether, 4,607 individuals developed dementia during the follow-up period. The researchers noted that GLP-1 agonists were linked to a 30% lower risk of developing dementia compared to those prescribed with sulfonylureas and a 23% lower risk compared to those prescribed with DPP-4 inhibitors.
“This is important because it can help doctors make better decisions about which medicines to use for older patients with type 2 diabetes,” said study author Bowen Tang, a Ph.D. student in Sara Hägg’s research group at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, in a press release.
“However, proper randomized trials are needed to establish with certainty that GLP-1 agonists reduce the risk of dementia,” continued Tang.
Sources: Neuroscience News, eClinicalMedicine