Sodium-glucose cotransporter 2 (SGLT2) inhibitors exhibit potential benefits in reducing dementia risk, yet the optimal beneficiary subgroups remain uncertain.
Individuals with type 2 diabetes (T2D) initiating either SGLT2 inhibitor or sulfonylurea were identified from OneFlorida+ Clinical Research Network (2016–2022). A doubly robust learning was deployed to estimate risk difference (RD) and 95% confidence interval (CI) of all-cause dementia.
Among 35,458 individuals with T2D, 1.8% in the SGLT2 inhibitor group and 4.7% in the sulfonylurea group developed all-cause dementia over a 3.2-year follow-up, yielding a lower risk for SGLT2 inhibitors (RD, –2.5%; 95% CI, –3.0% to –2.1%). Hispanic ethnicity and chronic kidney disease were identified as the two important variables to define four subgroups in which RD ranged from –4.3% (–5.5 to –3.2) to –0.9% (–1.9 to 0.2).
Compared to sulfonylureas, SGLT2 inhibitors were associated with a reduced risk of all-cause dementia, but the association varied among different subgroups.

New users of sodium-glucose cotransporter 2 (SGLT2) inhibitors were significantly associated with a lower risk of all-cause dementia as compared to those of sulfonylureas.
The association varied among different subgroups defined by Hispanic ethnicity and chronic kidney disease.
A significantly lower risk of Alzheimer’s disease and vascular dementia was observed among new users of SGLT2 inhibitors compared to those of sulfonylureas.

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This post is Copyright: Huilin Tang,
William T. Donahoo,
Mikael Svensson,
C. Elizabeth Shaaban,
Glenn Smith,
Michael S. Jaffee,
Yu Huang,
Xia Hu,
Ying Lu,
Ramzi G. Salloum,
Steven T. DeKosky,
Jiang Bian,
Jingchuan Guo | July 3, 2024

Wiley: Alzheimer’s & Dementia: Table of Contents