Oral diabetes medication and risk of dementia in elderly patients with type 2 diabetes

• Published in: Diabetes research and clinical practice Vol. 154; pp. 116 - 123
• Main Authors: Kim, Ju Young, Ku, Young Sook, Kim, Hyun Jeong, Trinh, Nga Thi, Kim, Woorim, Jeong, Bomi, Heo, Tae Young, Lee, Myung Koo, Lee, Kyung Eun
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.08.2019
• Subjects: Dementia; Dipeptidyl peptidase 4 inhibitor; Metformin; Sulfonylurea; Thiazolidinedione; Type 2 diabetes mellitus; Dipeptidyl peptidase 4 inhibitor; Type 2 diabetes mellitus; Metformin; Sulfonylurea; Thiazolidinedione; Dementia; sulfonylurea; dementia; dipeptidyl peptidase 4 inhibitor; metformin; thiazolidinedione
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/j.diabres.2019.07.004

•Lower risk of dementia was observed in patients taking oral diabetes medications.•Association with lower risk of dementia was noticeable in combination therapy groups.•Sulfonylurea, metformin and DPP4 inhibitor group showed markedly lower risk of dementia. To examine the effect of oral diabetes medication on the risk of dementia in an elderly cohort with type 2 diabetes. 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. 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). Overall, the use of oral diabetes medication in type 2 diabetes patients significantly decreased the risk of dementia.