The following is a summary of “SGLT2 Inhibitor Use and Risk of Dementia and Parkinson’s Disease Among Patients With Type 2 Diabetes,” published in the September 2024 issue of Neurology by Kim et al.  

Researchers conducted a retrospective study to examine if using sodium-glucose cotransporter 2 inhibitor (SGLT2i) was linked to a lower risk of dementia or Parkinson’s disease (PD) in people with type 2 diabetes (T2D).  

They analyzed 1,348,362 participants with T2D (≥40 years) who began antidiabetic treatment (2014 and 2019). Propensity score matching (1:1; SGLT2i vs. other oral antidiabetic drugs [OADs]) resulted in a cohort of 358,862. The primary outcomes were the incidence of Alzheimer’s disease (AD), vascular dementia (VaD), and PD, while secondary outcomes included all-cause dementia (AD, VaD, and others) and a composite of dementia and PD. Cox proportional hazards models assessed the association of SGLT2i with dementia and PD risks.  

The results showed 358,862 participants analyzed (mean [SD] age, 57.8 [9.6] years; 58.0% male), 6,837 dementia or PD events occurred, SGLT2i use was linked to lower risks of AD (aHR 0.81, 95% CI 0.76–0.87), VaD (aHR 0.69, 95% CI 0.60–0.78), and PD (aHR 0.80, 95% CI 0.69–0.91) with a 6-month drug use lag, SGLT2i also showed a 21% reduced risk of all-cause dementia (aHR 0.79, 95% CI 0.69–0.90) and a 22% reduced risk of all-cause dementia plus PD compared to other oral antidiabetic drugs (OADs) (aHR 0.78, 95% CI 0.73–0.83). The risk reductions remained consistent across sex, Charlson Comorbidity Index, diabetic complications, comorbidities, and medications. Sensitivity analyses adjusting for clinical factors, including blood pressure, glucose, lipid levels, and kidney function, confirmed similar outcomes.  

 Investigators concluded that in a large-scale study, using SGLT2i was significantly linked to a lower risk of neurodegenerative diseases in people with T2D, even when considering other factors. 

Source: neurology.org/doi/10.1212/WNL.0000000000209805