Evidence mapPaperPMID 40761983Full record

ArticleCureus2025

Utility of Pharmacological Agents for Diabetes Mellitus in the Prevention of Alzheimer's Disease: Comparison of Metformin, Glucagon-Like Peptide-1 (GLP-1) Agonists, Insulin, and Sulfonylureas.

Alexandra DiGiovanni, Andrea Shehaj, David Millar, Claire Tse, Elias Rizk

Abstract read
In one paragraph

Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

5 authors.

Alexandra DiGiovanniDepartment of Neurosurgery, Penn State College of Medicine, Hershey, USA.
Andrea ShehajDepartment of Neurosurgery, Penn State College of Medicine, Hershey, USA.
David MillarDepartment of Neurosurgery, Penn State College of Medicine, Hershey, USA.
Claire TseDepartment of Neurosurgery, Penn State College of Medicine, Hershey, USA.
Elias RizkDepartment of Neurosurgery, University of Texas at Austin, Austin, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMetformin is a drug primarily used for the treatment of diabetes mellitus (DM), but it also offers clinical benefits that extend beyond glycemic control. Existing literature provides an unclear conclusion as to whether metformin's benefits extend to preventing neurodegeneration, such as in Alzheimer's disease (AD).

methodsA retrospective database study was conducted to evaluate the likelihood of developing AD in DM patients taking metformin compared to those taking glucagon-like peptide (GLP-1) analogs, sulfonylureas, and short-acting insulin variants. An analysis was also run to assess whether metformin has a protective benefit for AD and mortality when used in those with DM compared to those without DM.

resultsIn analyses totaling greater than 2.5 million patients, those on metformin had lower A1C percentages and a decreased mortality risk when compared to sulfonylureas (HR = 0.519, (CI: (0.493,0.546)), and short-acting insulins (HR = 0.372, (CI: (0.364,0.380)). Metformin use for DM was associated with a statistically significant increased likelihood of AD diagnosis compared to GLP-1 use (HR = 2.228, CI: (1.036,4.794)) but an insignificant difference compared to both sulfonylureas and insulins. Those with DM were at a significantly higher risk of being diagnosed with Alzheimer's compared to those without DM (HR = 1.826, (CI: 1.579, 2.111)).

conclusionsMetformin, previously thought to have significant benefits in preventing neurodegeneration, may not be the optimal pharmacologic agent of choice, particularly in patients with DM, if neurodegeneration is a primary concern in treatment decision-making based on other risk factors.

Indexed as

alzheimer's diseasediabetes mellitusglp-1 receptor agonistinsulinmetforminpharmacologysulfonylurea

Identifiers

PMID40761983
PMCPMC12321270

What Socratic holds

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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.