Risk for dementia found to be similar with SGLT2 inhibitors, dulaglutide in type 2 diabetes

For older adults with type 2 diabetes, the risk for dementia seems similar with sodium-glucose cotransporter 2 (SGLT2) inhibitors and the glucagon-like peptide 1 receptor agonist (GLP-1 RA) dulaglutide, according to a study published online Aug. 27 in the Annals of Internal Medicine.

Bin Hong, from the School of Pharmacy at Sungkyunkwan University in Suwon, South Korea, and colleagues compared the risk for dementia between SGLT2 inhibitors and dulaglutide in a target trial emulation study using nationwide health care data for South Korea obtained between 2010 and 2022.

Participants were aged 60 years or older with type 2 diabetes and were initiating treatment with SGLT2 inhibitors (12,489 patients; 51.9 percent dapagliflozin and 48.1 percent empagliflozin) or dulaglutide (1,075 patients).

The researchers found that during a median follow-up of 4.4 years, the primary outcome event of presumed clinical onset of dementia occurred in 69 and 43 participants in the SGLT2 and dulaglutide groups, respectively, with an estimated risk difference of −0.91 percentage points (95 percent confidence interval, −2.45 to 0.63) and estimated risk ratio of 0.81 (95 percent confidence interval, 0.56 to 1.16).

“In conclusion, we found little difference in the risk for dementia for SGLT2 inhibitors compared with dulaglutide in our data,” the authors write. “However, whether these findings generalize to newer GLP-1 RAs is uncertain.”

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