November 30, 2024Naunyn-Schmiedeberg s Archives of Pharmacology11 citationsOpen Access

Correlation between the utilization of sodium-glucose cotransporter-2 (SGLT2) inhibitors and the risk of dementia: a nationwide population-based study in Taiwan

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Type 2 diabetes mellitus (T2DM) (n=305810). Intervention: Sodium-glucose cotransporter-2 (SGLT2) inhibitors vs. Non-SGLT2i users. Primary outcome: Newly diagnosed dementia (aHR 0.53, 95% CI 0.50-0.57, p=<0.001).

WCWu-Lung Chuang STStella Chin‐Shaw Tsai YYYichun Yang

Key Result

SGLT2 inhibitors significantly reduced the risk of newly diagnosed dementia by 47% (aHR 0.53) compared to non-use in patients with type 2 diabetes mellitus.

Study Design

Type

Cohort (n=305,810)

Multicenter

Yes

Structured PICO

Do SGLT2 inhibitors reduce the risk of dementia in patients with type 2 diabetes mellitus?

Population

Patients with type 2 diabetes mellitus (T2DM) in Taiwan

Intervention

Sodium-glucose cotransporter 2 (SGLT2) inhibitors administered between 2016 and 2019

Comparator

Patients who did not receive SGLT2 inhibitors, propensity score matched 1:1 by sex, age, index date year, insurance fee, urbanization, comorbidities, and medications

Outcome

Risk of dementiahard clinical

In a nationwide Taiwanese cohort of patients with type 2 diabetes, SGLT2 inhibitor use was associated with a significantly lower risk of dementia compared to non-use.

Main Result

Effect estimate: aHR 0.53 (95% CI 0.50-0.57)

Absolute Event Rate: 3.62% vs 7.16%

p-value: p=<0.001

Limitations

Propensity score matching may have caused the control group to not accurately reflect the true prevalence of comorbidities or demographic characteristics.
Mean follow-up of approximately 2 years may be too short to fully capture long-term dementia development.
Potential surveillance bias due to differences in healthcare convenience between urban and rural areas.
Lack of hematology data in the NHIRD prevented inclusion of HbA1c and diabetes duration as covariates.
Baseline blood pressure and blood pressure changes after SGLT2i treatment were unknown.

Abstract

The impact of sodium-glucose cotransporter 2 inhibitors (SLGT2i) usage on reducing the risk of dementia remains uncertain. Our research seeks to establish the association between dementia risk and SLGT2 inhibitors among individuals with diabetes. This study relied on data from the Taiwan National Health Insurance Database (NHIRD), which was established in 1995 coinciding with the launch of the National Health Insurance (NHI) program by the Taiwanese government. The NHI program was implemented to enhance the healthcare system and public health in Taiwan. Patients with type 2 diabetes mellitus (T2DM) administered SGLT2i between 2016 and 2019 were included in the SGLT2i cohort. The comparison cohort consisted of patients who did not receive SGLT2i, propensity score matching by sex, age (in 5-y intervals), index date year, insurance fee, urbanization, comorbidities, and medications, with a 1:1 ratio of the exposure group. SGLT2i users had a significantly lower risk of dementia than non-SGLT2i users after adjusting for age, sex, insurance fees, urbanization, comorbidities, and medications (adjusted HR = 0.53, 95%CI: 0.50-0.57). The results revealed that patients treated with SGLT2i have a lower risk of dementia in Taiwan.

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Cite This Study

Chuang et al. (Sat,) conducted a cohort in Type 2 diabetes mellitus (T2DM) (n=305,810). Sodium-glucose cotransporter-2 (SGLT2) inhibitors vs. Non-SGLT2i users was evaluated on Newly diagnosed dementia (aHR 0.53, 95% CI 0.50-0.57, p=<0.001). SGLT2 inhibitors significantly reduced the risk of newly diagnosed dementia by 47% (aHR 0.53) compared to non-use in patients with type 2 diabetes mellitus.

synapsesocial.com/papers/6a0ca2cc5712c53037e8bbdc https://doi.org/https://doi.org/10.1007/s00210-024-03660-0

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