Affiliations: [a] Neuropsychiatric practice, Berlin, Germany
| [b] Faculty of Medicine, University of Paris 5, Paris, France
| [c]
Epidemiology, IQVIA, Frankfurt, Germany
Correspondence:
[*]
Correspondence to: Prof. Dr. rer. med. Karel Kostev, Epidemiology, IQVIA, Commercial GmbH & Co OHG, Unterschweinstiege 2-14, 60549 Frankfurt am Main, Germany. Tel.: +49 0 69 66 04 4878; E-mail: kkostev@de.imshealth.com.
Abstract: Background: There is a conflicting literature on the association between the use of antihyperglycemic drugs and dementia risk. Objective: The goal of this case-control study was to analyze the association between the use of antihyperglycemic drugs and dementia risk in patients followed in general practices in Germany. Methods: This study included patients with type 2 diabetes mellitus who had received a first dementia diagnosis in 972 general practices in Germany between January 2013 and December 2017 (index date). Controls without dementia were matched (1:1) to cases by age, gender, index year, and physician. Two multivariate regression models were used to study the association between the use of antihyperglycemic drugs and dementia risk. Model 1 included all antihyperglycemic drugs prescribed to patients regardless of the prescription duration, whereas Model 2 only included the longest therapy prescribed to each patient. Results: There were 8,276 diabetes patients with dementia and 8,276 diabetes patients without dementia included in this study. In Model 1, glitazones were associated with a decreased dementia risk (odds ratio [OR] = 0.80), whereas insulin was associated with an increased risk of developing the condition (OR = 1.34). In Model 2, metformin, prescribed as monotherapy (OR = 0.71) or as dual therapy with sulfonylureas (OR = 0.90), was associated with a decrease in the likelihood of subsequently being diagnosed with dementia. By contrast, the combination of basal insulin and bolus insulin (OR = 1.47) and premix insulin (OR = 1.33) were risk factors for dementia. Conclusion: Metformin and glitazones were negatively associated with dementia, while insulin was positively associated with dementia.
