How does metformin therapy for type 2 diabetes mellitus (DM) affect the risk of developing dementia?

Updated: Oct 23, 2019
  • Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD  more...
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Answer

Metformin may also decrease the risk of dementia associated with type 2 diabetes. In a 2013 observational study of 14,891 patients aged 55 years and older with type 2 diabetes, treatment with metformin signlificantly lowered the risk of developing dementia. [237] Only patients who initiated therapy with a single drug (metformin, sulfonylureas [SU], thiazolidinediones [TZDs], or insulin) during the study period were included.

During 5 years of followup, dementia was diagnosed in 1487 (9.9%) patients. [237] Compared with patients starting SU, those starting metformin had about a 20% reduced risk for dementia. Compared with patients starting TZD, those starting metformin had a 23% lower risk. [237]

Conversely, starting SU treatment (compared with metformin) was associated with a 24% increased risk for dementia; starting TZD treatment was associated with an 18% increased risk; and starting insulin treatment was associated with a 28% increased risk. [237]


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