GLP-1 receptor agonists, a category of drug used to deal with kind 2 diabetes, doubtless trump the broadly prescribed metformin for curbing dementia danger in folks with the situation, finds the biggest research of its type, revealed within the open entry journal BMJ Open Diabetes Analysis & Care.
The findings counsel that future scientific pointers for the remedy of kind 2 diabetes would do effectively to contemplate 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, shield the brains of individuals with the illness. However as but there have been no direct real-world comparisons of the potential impression of those medicine on dementia danger—a danger that’s round 70% increased in folks with kind 2 diabetes.
To discover this additional, the researchers drew on anonymized digital well being information 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 a minimum of six consecutive months.
There was no vital distinction in vascular dementia danger between the 2 sorts of drug when used as first line remedy.
However GLP-1 receptor agonist use was related to a considerably decrease cumulative (10%) danger of growing dementia, total, with an incidence of virtually 2.5% (2,130 folks) in contrast with an incidence of almost 5% (4,215 folks) for metformin.
And particularly, taking this sort of drug was related to a 12% decrease danger of growing Alzheimer’s illness, and a 25% decrease danger of growing 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, girls, and people of white ethnicity.
Danger of dying from any trigger was additionally decrease: almost 5% of these handled with GLP-1 receptor agonists died in contrast with almost 9% of these handled with metformin.
“Each medicines display neuroprotective properties, corresponding to lowering neuroinflammation and oxidative stress, bettering insulin sensitivity, and enhancing cerebrovascular well being, which doubtless contribute to their advantages in total dementia,” clarify the researchers.
However not like 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.
“Nevertheless, the multifactorial nature of [vascular dementia], pushed by cerebrovascular harm, corresponding to small vessel illness and white matter lesions, poses vital challenges for pharmacological interventions concentrating on metabolic or neurodegenerative pathways,” they proceed.
That is an observational research, and as such, no agency conclusions could be drawn about trigger and impact. And the researchers level out that the monitoring interval, whereas ample for observing dementia outcomes, might not totally 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 elevate vital issues concerning the function of GLP-1 [receptor agonists] as first-line therapies in [type 2 diabetes] administration.
“Whereas additional long-term research are warranted to validate these outcomes, integrating GLP-1 [receptor agonists] as major therapeutic brokers might characterize a paradigm shift in stopping the cognitive problems of diabetes.”
Extra data:
Evaluating GLP-1 receptor agonists versus metformin as first-line remedy for lowering dementia danger in kind 2 diabetes, BMJ Open Diabetes Analysis & Care (2025). DOI: 10.1136/bmjdrc-2025-004902
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GLP-1 diabetes medicine doubtless trump metformin for curbing dementia danger in kind 2 diabetes, research finds (2025, July 22)
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