Evidence mapPaperPMID 40695613Full record

ArticleBMJ open diabetes research & care2025

Evaluating GLP-1 receptor agonists versus metformin as first-line therapy for reducing dementia risk in type 2 diabetes.

Mingyang Sun, Xiaoling Wang, Zhongyuan Lu, Yitian Yang, Shuang Lv, Mengrong Miao, Wan-Ming Chen, Szu Yuan Wu, Jiaqiang Zhang

Abstract readComparative Study
In one paragraph

Article in BMJ open diabetes research & care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
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

2 citing papers in PubMed.

  1. Review
  2. 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

9 authors.

Mingyang SunDepartment of Anesthesiology and Perioperative Medicine, People's Hospital of Zhengzhou University Zhengzhou University,Henan Provincial People's Hospital, Zhengzhou, Henan, China zhangjiq@zzu.edu.cn szuyuanwu5399@gmail.com mingyangsun1986@163.com.
Xiaoling WangDepartment of Anesthesiology and Perioperative Medicine, People's Hospital of Zhengzhou University Zhengzhou University,Henan Provincial People's Hospital, Zhengzhou, Henan, China.
Zhongyuan LuDepartment of Anesthesiology and Perioperative Medicine, People's Hospital of Zhengzhou University Zhengzhou University,Henan Provincial People's Hospital, Zhengzhou, Henan, China.
Yitian YangDepartment of Anesthesiology and Perioperative Medicine, People's Hospital of Zhengzhou University Zhengzhou University,Henan Provincial People's Hospital, Zhengzhou, Henan, China.
Shuang LvDepartment of Anesthesiology and Perioperative Medicine, People's Hospital of Zhengzhou University Zhengzhou University,Henan Provincial People's Hospital, Zhengzhou, Henan, China.
Mengrong MiaoDepartment of Anesthesiology and Perioperative Medicine, People's Hospital of Zhengzhou University Zhengzhou University,Henan Provincial People's Hospital, Zhengzhou, Henan, China.
Wan-Ming ChenGraduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei, Taiwan.
Szu Yuan WuGraduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei, Taiwan zhangjiq@zzu.edu.cn szuyuanwu5399@gmail.com mingyangsun1986@163.com.ORCID http://orcid.org/0000-0001-5637-558X
Jiaqiang ZhangDepartment of Anesthesiology and Perioperative Medicine, People's Hospital of Zhengzhou University Zhengzhou University,Henan Provincial People's Hospital, Zhengzhou, Henan, China zhangjiq@zzu.edu.cn szuyuanwu5399@gmail.com mingyangsun1986@163.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionNo direct comparisons have evaluated glucagon-like peptide-1 receptor agonists (GLP-1 RAs) versus metformin as first-line antidiabetic therapy for preventing dementia in patients with type 2 diabetes mellitus (T2DM). This study aimed to assess the comparative effectiveness of GLP-1 RAs and metformin in reducing dementia risk. RESEARCH DESIGN AND

methodsThis retrospective cohort study used data from a global health research network between 2004 and 2024. Patients with T2DM initiating GLP-1 RAs or metformin as first-line monotherapy were included. Propensity score matching was employed to balance baseline characteristics. Dementia incidence was analyzed using Cox proportional hazards models, with sensitivity analyses to confirm robustness.

resultsAmong 87,229 matched patients per cohort, GLP-1 RA use was associated with a significantly lower risk of overall dementia (adjusted HR (AHR) 0.90; 95% CI 0.85 to 0.95), Alzheimer's disease (AD) (AHR 0.88; 95% CI 0.83 to 0.94), and non-vascular dementias (non-VaDs) (AHR 0.75; 95% CI 0.70 to 0.81) compared with metformin. No significant difference was observed for VaD. Subgroup analyses showed consistent benefit across age and sex, with the strongest effect among older adults and females.

conclusionsGLP-1 RAs were more effective than metformin in reducing the risk of dementia-especially AD and non-vascular types-highlighting their potential as a preferred first-line treatment in T2DM. Further randomized trials are warranted to validate these findings.

Indexed as

DementiaDiabetes Mellitus, Type 2Glucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsMetforminAgedAged, 80 and overFemaleFollow-Up StudiesHumansIncidenceMaleMiddle AgedRetrospective StudiesRisk FactorsGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsMetforminDementiaDiabetes Mellitus, Type 2Glucagon-Like Peptide 1Metformin

Identifiers

PMID40695613
PMCPMC12306345

What Socratic holds

Texttitle and abstract
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Registered trials

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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.