GLP-1 RAs, SGLT2 Inhibitors May Reduce Risk for Alzheimer Disease, Dementia in T2DM

THURSDAY, April 17, 2025 (HealthDay News) — Both glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2is) are associated with a reduced risk for Alzheimer disease and related dementias (ADRDs) among people with type 2 diabetes (T2D), according to a study published online April 7 in JAMA Neurology.

Huilin Tang, Ph.D., from the University of Florida College of Pharmacy in Gainesville, and colleagues examined the risk for ADRDs associated with GLP-1 RAs and SGLT2is in people with T2D in a target trial emulation study using electronic health record data. There were 396,963 eligible patients with T2D, of whom 33,858 were included in the GLP-1 RA versus the other glucose-lowering drug (GLD) cohort; 34,185 in the SGLT2i versus the other GLD cohort; and 24,117 in the GLP-1 RA versus SGLT2i cohort.

The researchers found that in inverse probability of treatment weighting-weighted cohorts, the incidence rate of ADRD was lower in GLP-1 RA initiators versus other GLD initiators and in SGLT2i initiators versus other GLD initiators, yielding hazard ratios of 0.67 and 0.57, respectively. No significant difference was seen between GLP-1 RAs and SGLT2is.

“These results support the potential neuroprotections of GLP-1 RAs and SGLT2is and highlight their possible role in ADRD prevention strategies. The comparable association between GLP-1 RAs and SGLT2is provides flexibility in treatment choices while potentially offering cognitive benefits,” the authors write.

Several authors disclosed ties to the pharmaceutical and medical technology industries.

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