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Comparative study of SGLT2 inhibitors and metformin: Evaluating first-line therapies for dementia prevention in type 2 diabetes - PubMed

6 hours ago
  • #Type 2 Diabetes
  • #SGLT2 Inhibitors
  • #Dementia Prevention
  • Type 2 diabetes (T2D) raises dementia risk by 1.5 to 2.5 times.
  • SGLT2 inhibitors (SGLT2is) and metformin are antidiabetic drugs with neuroprotective potential.
  • This retrospective cohort study used TriNetX data to compare SGLT2i vs. metformin as first-line therapy in T2D patients.
  • Propensity score-matched cohorts (74,975 each) showed SGLT2i associated with lower overall dementia incidence: 2.7% vs. 6.9% (aHR 0.80).
  • SGLT2i also reduced vascular dementia (aHR 0.87), Alzheimer's dementia (aHR 0.76), and all-cause mortality (aHR 0.92).
  • Benefits were more pronounced in older adults, especially those aged ≥80 years.
  • Conclusions suggest SGLT2is may offer superior neuroprotective benefits over metformin for dementia prevention in T2D.
  • Further randomized trials are needed to confirm these results.