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Diabetes and Obesity Drugs May Reduce Risk of Dementia For Older Diabetes Patients

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Older people with type 2 diabetes who are treated with GLP-1 agonists have a decreased risk of developing dementia, according to a new study from Karolinska Institutet published in the journal eClinicalMedicine.

Drugs known as GLP-1 agonists or GLP-1 analogues have become increasingly popular in treating type 2 diabetes and obesity as they help control blood sugar, promote weight loss and protect the heart.

People with type 2 diabetes have an increased risk of developing dementia and it’s been hypothesised that newer diabetes drugs such as GLP-1 agonists and DPP-4 inhibitors might have a protective effect.

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In the new register-based study, researchers followed more than 88,000 older individuals with type 2 diabetes for up to ten years. Using a study design called target trial emulation, which imitates a randomised clinical trial, they analysed the association between three diabetes drugs (GLP-1 agonists, DPP-4 inhibitors or sulfonylureas) and the risk of dementia.

Can help doctors make better decisions 

They found that patients who used GLP-1 agonists had a 30 per cent lower risk of developing dementia compared to those who used sulfonylureas, and a 23 per cent lower risk compared to those who used 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,” says Bowen Tang, a PhD student in Sara Hägg’s research group at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet. “However, proper randomised trials are needed to establish with certainty that GLP-1 agonists reduce the risk of dementia.”

The study was funded by the Swedish Research Council, Karolinska Institutet, the National Institute on Aging, the National Institutes of Health, and Riksbankens Jubileumsfond. There are no reported conflicts of interest.

Reference: Tang B, Sjölander A, Wastesson JW, et al. Comparative effectiveness of glucagon-like peptide-1 agonists, dipeptidyl peptidase-4 inhibitors, and sulfonylureas on the risk of dementia in older individuals with type 2 diabetes in Sweden: an emulated trial study. eClinicalMedicine. 2024:102689. doi: 10.1016/j.eclinm.2024.102689

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