Evidence map›Paper›PMID 36109050›Full record

ArticleBMJ open diabetes research & care2022

Comparative effect of metformin versus sulfonylureas with dementia and Parkinson's disease risk in US patients over 50 with type 2 diabetes mellitus.

Danielle Newby, Andrew Brent Linden, Marco Fernandes, Yasmina Molero, Laura Winchester, William Sproviero, Upamanyu Ghose, Qingqin S Li, Lenore J Launer, Cornelia M van Duijn and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open diabetes research & care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 2 pooled it
4.6field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 35 citations in OpenAlex.

  1. Pooled it
  2. Do oral antidiabetic medications alter the risk of Parkinson's disease? An updated systematic review and meta-analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2023 · on this map
    Pooled it
  3. Journal of Alzheimer's disease : JAD · 2026
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  16. Observational
  17. Antidiabetic drugs in Parkinson's disease.Clinical parkinsonism & related disorders · 2024
    Review
  18. Artificial intelligence for dementia prevention.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2023
    Review
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  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 6 institutions in 4 countries.

Danielle NewbyPsychiatry, University of Oxford, Oxford, UK danielle.newby@ndorms.ox.ac.uk.ORCID 0000-0002-3001-1478
Andrew Brent LindenNuffield Department of Population Health, University of Oxford, Oxford, UK.
Marco FernandesPsychiatry, University of Oxford, Oxford, UK.
Yasmina MoleroClinical Neuroscience, Center for Psychiatry Research, Karolinska Institute, Stockholm, Sweden.
Laura WinchesterPsychiatry, University of Oxford, Oxford, UK.
William SprovieroPsychiatry, University of Oxford, Oxford, UK.
Upamanyu GhosePsychiatry, University of Oxford, Oxford, UK.
Qingqin S LiNeuroscience, Janssen Research and Development, Titusville, New Jersey, USA.
Lenore J LaunerLaboratory of Epidemiology and Population Science, National Institute on Aging, Bethesda, Maryland, USA.
Cornelia M van DuijnNuffield Department of Population Health, University of Oxford, Oxford, UK.
Alejo J Nevado-HolgadoPsychiatry, University of Oxford, Oxford, UK.
University of Oxford · GBErasmus MC · NLJanssen (United States) · USKarolinska Institutet · SENational Institute on Aging · USNuffield Orthopaedic Centre · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionType 2 diabetes is a risk factor for dementia and Parkinson's disease (PD). Drug treatments for diabetes, such as metformin, could be used as novel treatments for these neurological conditions. Using electronic health records from the USA (OPTUM EHR) we aimed to assess the association of metformin with all-cause dementia, dementia subtypes and PD compared with sulfonylureas. RESEARCH DESIGN AND

methodsA new user comparator study design was conducted in patients ≥50 years old with diabetes who were new users of metformin or sulfonylureas between 2006 and 2018. Primary outcomes were all-cause dementia and PD. Secondary outcomes were Alzheimer's disease (AD), vascular dementia (VD) and mild cognitive impairment (MCI). Cox proportional hazards models with inverse probability of treatment weighting (IPTW) were used to estimate the HRs. Subanalyses included stratification by age, race, renal function, and glycemic control.

resultsWe identified 96 140 and 16 451 new users of metformin and sulfonylureas, respectively. Mean age was 66.4±8.2 years (48% male, 83% Caucasian). Over the 5-year follow-up, 3207 patients developed all-cause dementia (2256 (2.3%) metformin, 951 (5.8%) sulfonylurea users) and 760 patients developed PD (625 (0.7%) metformin, 135 (0.8%) sulfonylurea users). After IPTW, HRs for all-cause dementia and PD were 0.80 (95% CI 0.73 to 0.88) and 1.00 (95% CI 0.79 to 1.28). HRs for AD, VD and MCI were 0.81 (0.70-0.94), 0.79 (0.63-1.00) and 0.91 (0.79-1.04). Stronger associations were observed in patients who were younger (<75 years old), Caucasian, and with moderate renal function.

conclusionsMetformin users compared with sulfonylurea users were associated with a lower risk of all-cause dementia, AD and VD but not with PD or MCI. Age and renal function modified risk reduction. Our findings support the hypothesis that metformin provides more neuroprotection for dementia than sulfonylureas but not for PD, but further work is required to assess causality.

Indexed as

DementiaDiabetes Mellitus, Type 2MetforminParkinson DiseaseAgedFemaleHumansHypoglycemic AgentsMaleMiddle AgedSulfonylurea CompoundsHypoglycemic AgentsMetforminSulfonylurea CompoundsAlzheimer DiseaseDementiaDiabetes Mellitus, Type 2Neurology

Identifiers

PMID36109050
PMCPMC9478804
OpenAlexW4295941524

What Socratic holds

Texttitle and abstract
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.