WEDNESDAY, Oct. 12, 2022 (HealthDay News) — For patients with type 2 diabetes (T2D), thiazolidinedione (TZD) monotherapy is associated with reduced dementia risk compared with metformin (MET) monotherapy, while sulfonylurea (SU) monotherapy is associated with an increased risk, according to a study published online Oct. 12 in BMJ Open Diabetes Research & Care.

Xin Tang, from the University of Arizona Mel and Enid Zuckerman College of Public Health in Tucson, and colleagues conducted a prospective observational study within a T2D population (aged 60 years or older at initiation) who initiated antidiabetic medications (ADM) from Jan. 1, 2001, to Dec. 31, 2017, and who were dementia-free. Based on prescription records, an SU monotherapy group, TZD monotherapy group, and control group (MET monotherapy) were identified; participants were required to take the assigned treatment for a minimum of one year. Data were included for 559,106 eligible veterans.

The researchers found that the all-cause dementia rate was 8.2 cases per 1,000 person-years. After at least one year of treatment, the risk for all-cause dementia was significantly reduced with TZD monotherapy versus MET monotherapy (hazard ratio, 0.78) and was also significantly reduced with MET and TZD dual therapy (hazard ratio, 0.89). With SU monotherapy, the risk was significantly increased (hazard ratio, 1.12).

“Our findings provide additional information to aid clinicians’ selection of ADMs for patients with mild or moderate T2D and are at high risk of dementia,” the authors write.

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