Collocation of metformin and dipeptidyl peptidase-4 inhibitor is associated with increased risk of diabetes-related vascular dementia: A single hospital study in Northern Taiwan

Expert Opin Investig Drugs. 2023 Feb;32(2):171-176. doi: 10.1080/13543784.2023.2178417. Epub 2023 Feb 17.

Abstract

Background: Recent studies have established a close link between diabetes mellitus (DM) and an increased risk of vascular dementia (VD). In this study, we evaluated the risk of VD in patients with type 2 diabetes who were on antidiabetic medications.

Methods: There is a growing interest in observational and data-driven studies to answer specific research questions for defined populations. In line with this, 67,281 patients (age range, 61.95 ± 13.88 years; length of follow up, 3.2 ± 3.4 years) diagnosed with DM were divided into two groups:48,072 subjects who had not used dipeptidyl peptidase-4 (DPP-4) medication and 19,209 subjects who had taken DPP-4 medication. Each patient underwent follow-up examination after the date of the latest diagnosis.

Results: Among 10,884 DM patients with dementia, the combination therapy of metformin and DPP-4 inhibitor may increase the risk of dementia compared with that in the control group (adjusted hazard ratio, 1.11; 95% confidence interval, 1.06-1.15; p ≤ 0.001).

Conclusion: In this study, patients who received a combination therapy of metformin and DPP-4 inhibitor for DM were at a higher risk of dementia than those who received monotherapy.

Keywords: Vascular dementia; diabetes mellitus; dipeptidyl peptidase 4 inhibitors; metformin; risk factors.

MeSH terms

  • Aged
  • Dementia, Vascular* / chemically induced
  • Dementia, Vascular* / etiology
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / drug therapy
  • Dipeptidyl-Peptidase IV Inhibitors* / adverse effects
  • Hospitals
  • Humans
  • Hypoglycemic Agents / adverse effects
  • Metformin* / adverse effects
  • Middle Aged
  • Taiwan / epidemiology

Substances

  • Dipeptidyl-Peptidase IV Inhibitors
  • Hypoglycemic Agents
  • Metformin