Cognitive protection of incretin‐based therapies in patients with type 2 diabetes mellitus: A systematic review and meta‐analysis based on clinical studies

Abstract

Aims/introduction Cognitive dysfunction, including mild cognitive impairment and dementia, is increasingly recognized as an important complication of type 2 diabetes mellitus. The aims of the preset study was to investigate the cognitive protection of incretin‐based therapies, including glucagon‐like peptide‐1 receptor agonists and dipeptidyl peptidase‐4 inhibitors, in patients with type 2 diabetes mellitus. Materials and Methods PubMed, EMBASE, Cochrane library, Web of Science and PsycINFO were searched from the inception through 17 January 2023 for randomized controlled trials and cohort studies on the association between incretin‐based therapies and cognitive function. A total of 15 studies were finally included in our systematic review, and eight of which were incorporated into our meta‐analysis. Results Pooled results showed that the Mini‐Mental State Examination score in incretin‐based therapy groups was increased by 1.20 compared with the control group (weighted mean difference 1.20, 95% confidence interval 0.39–2.01). The results of eight studies assessed by the Newcastle Ottawa Quality Assessment Scale and the Cochrane Collaboration's tool, and the quality of the eight studies were at a relatively high level. Egger's regression did not show significant publication bias. Conclusions Current evidence shows that incretin‐based therapies might be more effective, when compared with the other hypoglycemic drugs, for cognitive improvement in patients with type 2 diabetes mellitus.

review of variable risk factors affecting the development of mild cognitive impairment in older adults

“…Some glucose-lowering drugs have been shown to improve cognitive function in patients. Recent studies have found that glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and DPP-IV inhibitors are effective in ameliorating cognitive impairment in diabetic patients [23]. GLP-1 acts as a physiological modulator of the central nervous system and enhances learning and memory function by restoring insulin signaling [24].…”

Comparing major and mild cognitive impairment risks in older type-2 diabetic patients: a Danish register-based study on dipeptidyl peptidase-4 inhibitors vs. glucagon-like peptide-1 analogues

“…Incretin-based treatments, which are widely used glucose-lowering drugs, have recently shown promise in improving cognitive functions among individuals with type-2 diabetes, positioning themselves as potential therapeutic agents for major CI [ 4 , 5 ]. Notably, a recent meta-analysis of cohort studies revealed that dipeptidyl peptidase-4 inhibitors (DPP-4i) can significantly improve cognitive functions in patients with type-2 diabetes compared to other classes of glucose-lowering agents (i.e., sulfonylurea and metformin) [ 4 ].…”

“…Incretin-based treatments, which are widely used glucose-lowering drugs, have recently shown promise in improving cognitive functions among individuals with type-2 diabetes, positioning themselves as potential therapeutic agents for major CI [ 4 , 5 ]. Notably, a recent meta-analysis of cohort studies revealed that dipeptidyl peptidase-4 inhibitors (DPP-4i) can significantly improve cognitive functions in patients with type-2 diabetes compared to other classes of glucose-lowering agents (i.e., sulfonylurea and metformin) [ 4 ]. In addition, glucagon-like peptide-1 analogues (GLP-1a) have garnered increased attention as pharmacological treatments capable of improving cognitive functions, supported by positive results from preclinical studies and some observational research [ 6 , 7 ].…”