Evidence map›Paper›PMID 36220195›Full record

Observational studyBMJ open diabetes research & care2022

Use of oral diabetes medications and the risk of incident dementia in US veterans aged ≥60 years with type 2 diabetes.

Xin Tang, Roberta Diaz Brinton, Zhao Chen, Leslie V Farland, Yann Klimentidis, Raymond Migrino, Peter Reaven, Kathleen Rodgers, Jin J Zhou

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

Observational study 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 18 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 4 pooled it
4.9field-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

18 citing papers in PubMed, 4 syntheses or guidelines pooled it, 38 citations in OpenAlex.

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  4. 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
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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

9 authors at 2 institutions in 1 country.

Xin TangEpidemiology and Biostatistics, The University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA.ORCID 0000-0002-0827-9144
Roberta Diaz BrintonUA Center for Innovation in Brain Science, The University of Arizona Health Sciences, Tucson, Arizona, USA.
Zhao ChenEpidemiology and Biostatistics, The University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA.
Leslie V FarlandEpidemiology and Biostatistics, The University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA.
Yann KlimentidisDepartment of Epidemiology and Biostatistics, The University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA.
Raymond MigrinoDivision of Cardiology, The University of Arizona College of Medicine Phoenix, Phoenix, Arizona, USA.
Peter ReavenDivision of Endocrinology, Phoenix VA Health Care System, Phoenix, Arizona, USA.
Kathleen RodgersDepartment of Pharmacology and Toxicology, The University of Arizona, Tucson, Arizona, USA.
Jin J ZhouDepartment of Medicine, University of California, Los Angeles, California, USA jinjinzhou@ucla.edu.
University of Arizona · USUniversity of California, Los Angeles · US

Funding

Genomics, GPUs, and Next Generation Computational StatisticsR01HG006139 · NHGRI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI SOBEL, ERIC · 2011 to 2023
$5.1M
Develop T2D Patient-Centered Treatment Suggestion Rule using EMR dataK01DK106116 · NIDDK · UNIVERSITY OF ARIZONA · PI ZHOU, JIN · 2016 to 2019
$524k
A Role for Glycemic Variation in Optimizing Management of Diabetes and Vascular ComplicationsR21HL150374 · NHLBI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI REAVEN, PETER D, ZHOU, JIN · 2020 to 2021
$250k
Role of Methionine Sulfoxide and Advanced Glycation Endproducts in Cardiovascular and Renal Complications of Type 2 DiabetesR21HL150268 · NHLBI · ARIZONA VETERANS RESEARCH AND EDUCATION FOUNDATION · PI KOSKA, JURAJ, REAVEN, PETER D · 2019 to 2020
$223k
NHGRI NIH HHS R01 HG006139NHLBI NIH HHS R21 HL150268NHLBI NIH HHS R21 HL150374NIDDK NIH HHS K01 DK106116
6 · The paper itself

Abstract

introductionStudies have reported that antidiabetic medications (ADMs) were associated with lower risk of dementia, but current findings are inconsistent. This study compared the risk of dementia onset in patients with type 2 diabetes (T2D) treated with sulfonylurea (SU) or thiazolidinedione (TZD) to patients with T2D treated with metformin (MET). RESEARCH DESIGN AND

methodsThis is a prospective observational study within a T2D population using electronic medical records from all sites of the Veterans Affairs Healthcare System. Patients with T2D who initiated ADM from January 1, 2001, to December 31, 2017, were aged ≥60 years at the initiation, and were dementia-free were identified. A SU monotherapy group, a TZD monotherapy group, and a control group (MET monotherapy) were assembled based on prescription records. Participants were required to take the assigned treatment for at least 1 year. The primary outcome was all-cause dementia, and the two secondary outcomes were Alzheimer's disease and vascular dementia, defined by International Classification of Diseases (ICD), 9th Revision, or ICD, 10th Revision, codes. The risks of developing outcomes were compared using propensity score weighted Cox proportional hazard models.

resultsAmong 559 106 eligible veterans (mean age 65.7 (SD 8.7) years), the all-cause dementia rate was 8.2 cases per 1000 person-years (95% CI 6.0 to 13.7). After at least 1 year of treatment, TZD monotherapy was associated with a 22% lower risk of all-cause dementia onset (HR 0.78, 95% CI 0.75 to 0.81), compared with MET monotherapy, and 11% lower for MET and TZD dual therapy (HR 0.89, 95% CI 0.86 to 0.93), whereas the risk was 12% higher for SU monotherapy (HR 1.12 95% CI 1.09 to 1.15).

conclusionsAmong patients with T2D, TZD use was associated with a lower risk of dementia, and SU use was associated with a higher risk compared with MET use. Supplementing SU with either MET or TZD may partially offset its prodementia effects. These findings may help inform medication selection for elderly patients with T2D at high risk of dementia.

Indexed as

Diabetes Mellitus, Type 2MetforminThiazolidinedionesVeteransAgedDrug Therapy, CombinationHumansHypoglycemic AgentsRetrospective StudiesSulfonylurea CompoundsTreatment Outcome2,4-thiazolidinedioneHypoglycemic AgentsMetforminSulfonylurea CompoundsThiazolidinedionesDementiaPreventive Medicine

Identifiers

PMID36220195
PMCPMC9472121
OpenAlexW4304589935

What Socratic holds

Texttitle and abstract
LicenceCC BY-NC
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.