Dementia Incidence Increased With Termination of Metformin

Association largely independent of changes in hemoglobin A1c and insulin usage
Dementia Incidence Increased With Termination of Metformin
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FRIDAY, Oct. 27, 2023 (HealthDay News) -- Terminating metformin treatment is associated with an increased incidence of dementia, according to a study published online Oct. 25 in JAMA Network Open.

Scott C. Zimmerman, M.P.H., from the University of California in San Francisco, and colleagues examined the association of terminating metformin treatment for reasons unrelated to kidney dysfunction with dementia incidence in a cohort study of metformin users. The final analytic sample included 12,220 early terminators and 29,126 routine metformin users.

The researchers found that compared with routine users, the early terminators had a significantly increased risk for dementia diagnosis (hazard ratio, 1.21). Contributions to this association by changes in hemoglobin A1c (HbA1c) level or insulin use varied from no contribution for insulin use at five years after termination to 0.07 years for HbA1c level at one year after termination in a mediation analysis, indicating that the association was mainly independent of HbA1c level changes and insulin use.

"Terminating metformin treatment was associated with increased dementia incidence, corroborating prior observational research that initiating metformin was associated with reduced risk of dementia," the authors write. "This finding has important implications for the clinical management of diabetes."

One author disclosed ties to the pharmaceutical industry.

Abstract/Full Text

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