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

• Published in: Journal of diabetes investigation 2023-07, Vol.14 (7), p.864-873
• Main Authors: Chai, Sanbao, Liu, Fengqi, Yu, Shuqing, Yang, Zhirong, Sun, Feng
• Format: Article
• Language: English
• Subjects: Alzheimer's disease; Bias; Clinical trials; Cognition; Cognition & reasoning; Cognitive ability; Cognitive function; Cohort analysis; Collaboration; Confidence intervals; Dementia; Dementia disorders; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - chemically induced; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Dipeptidyl-Peptidase IV Inhibitors - adverse effects; GLP-1 receptor agonists; Glucagon; Glucagon-like peptide 1; Glucagon-Like Peptide-1 Receptor - agonists; Hemoglobin; Humans; Hypoglycemic Agents - adverse effects; Incretins - therapeutic use; Incretin‐based therapy; Insulin; Meta-analysis; Original; Peptides; Quality control; Questionnaires; Sensitivity analysis; Statistical significance; Systematic review; Type 2 diabetes
• ISSN: 2040-1116; 2040-1124
• DOI: 10.1111/jdi.14015

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. Cognitive dysfunction is recognized as an complication of type 2 diabetes mellitus. Incretin has emerged as a potential therapeutic agent for Alzheimer's disease. Incretin has a protective effect on cognitive function in type 2 diabetes mellitus patients.