SGLT2i Versus Metformin for Delirium Prevention in Type 2 Diabetes: A Real-World, Head- to-Head Comparative Study

What is it about?

People with type 2 diabetes (T2D) have a higher risk of developing delirium, a serious condition that causes confusion and cognitive decline. Delirium can lead to long-term memory problems and even increase the risk of dementia. Metformin has been the standard first-line treatment for T2D and has shown some benefits in reducing delirium risk. However, newer medications, such as sodium-glucose cotransporter-2 inhibitors (SGLT2is), may offer additional protection against delirium by improving brain energy metabolism, reducing inflammation, and promoting heart health. In this study, we compared SGLT2is with metformin to see which drug was better at preventing delirium in people with T2D. Using real-world health data from a large population, we found that patients taking SGLT2is had a lower risk of developing delirium compared to those using metformin. This effect was especially strong in high-risk groups, such as older adults and individuals with other health conditions like heart disease or insulin use. Additionally, patients on SGLT2is lived longer than those on metformin, meaning that the observed benefits might be even greater than our findings suggest. These results highlight the potential of SGLT2is as a valuable treatment option for T2D patients at risk for cognitive decline. Our study is the first to directly compare these two widely used diabetes medications for delirium prevention. These findings could help doctors make better treatment decisions and improve long-term brain health for people living with diabetes.

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