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GLP-1 receptor agonists, a category of drug used to deal with kind 2 diabetes, probably trump the broadly prescribed metformin for curbing dementia threat in folks with the situation, finds the biggest examine of its form, printed within the open entry journal BMJ Open Diabetes Analysis & Care.
The findings recommend that future scientific pointers for the therapy of kind 2 diabetes would do nicely to think about prioritizing medicine with each blood glucose and neuroprotective results, say the researchers.
Printed analysis means that each GLP-1 receptor agonists and metformin, that are broadly used to deal with kind 2 diabetes, defend the brains of individuals with the illness. However as but there have been no direct real-world comparisons of the potential affect of those medicine on dementia threat—a threat that’s round 70% increased in folks with kind 2 diabetes.
To discover this additional, the researchers drew on anonymized digital well being data from a worldwide well being analysis community (Trinetx) spanning the interval 2004 to 2024 to trace the event of dementia in sufferers with kind 2 diabetes, handled with both GLP-1 receptor agonists or metformin (87,229 sufferers in every group; common age 58) for at the least six consecutive months.
There was no important distinction in vascular dementia threat between the 2 varieties of drug when used as first line remedy.
However GLP-1 receptor agonist use was related to a considerably decrease cumulative (10%) threat of creating dementia, total, with an incidence of virtually 2.5% (2,130 folks) in contrast with an incidence of practically 5% (4,215 folks) for metformin.
And particularly, taking one of these drug was related to a 12% decrease threat of creating Alzheimer’s illness, and a 25% decrease threat of creating non-vascular dementias than metformin use.
Additional in-depth analyses confirmed that these optimistic results had been evident throughout all age teams, however with the strongest impact among the many over 60s, ladies, and people of white ethnicity.
Threat of dying from any trigger was additionally decrease: practically 5% of these handled with GLP-1 receptor agonists died in contrast with practically 9% of these handled with metformin.
“Both medications demonstrate neuroprotective properties, such as reducing neuroinflammation and oxidative stress, improving insulin sensitivity, and enhancing cerebrovascular health, which likely contribute to their benefits in overall dementia,” clarify the researchers.
However in contrast to metformin, whose advantages primarily derive from systemic metabolic results, GLP-1 receptor agonists exert direct central nervous system results by crossing the blood-brain barrier, they add.
“However, the multifactorial nature of [vascular dementia], driven by cerebrovascular damage, such as small vessel disease and white matter lesions, poses significant challenges for pharmacological interventions targeting metabolic or neurodegenerative pathways,” they proceed.
That is an observational examine, and as such, no agency conclusions will be drawn about trigger and impact. And the researchers level out that the monitoring interval, whereas adequate for observing dementia outcomes, could not absolutely seize long-term cognitive results, particularly given the progressive nature of Alzheimer’s illness.
However they nonetheless conclude, “Given the extreme societal, familial, and financial burden of diabetes-related dementia, these findings increase vital concerns in regards to the position of GLP-1 [receptor agonists] as first-line therapies in [type 2 diabetes] administration.
“While further long-term studies are warranted to validate these results, integrating GLP-1 [receptor agonists] as primary therapeutic agents may represent a paradigm shift in preventing the cognitive complications of diabetes.”
Extra data:
Evaluating GLP-1 receptor agonists versus metformin as first-line remedy for lowering dementia threat in kind 2 diabetes, BMJ Open Diabetes Analysis & Care (2025). DOI: 10.1136/bmjdrc-2025-004902
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British Medical Journal
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GLP-1 diabetes medicine probably trump metformin for curbing dementia threat in kind 2 diabetes, examine finds (2025, July 22)
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