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Dementia

Delaying Type 2 Diabetes Treatment May Forfeit Cognitive Protection

Strategic Insights

— 1 min read

Research from the People's Hospital of Zhengzhou University has found that delaying treatment with sodium-glucose cotransporter-2 inhibitors (SGLT2is) for type 2 diabetes (T2DM) until HbA1c levels reach 9% may forfeit protection against dementia. The study, which analyzed data from 150 health systems worldwide, suggests that earlier use of SGLT2is may safeguard brain, heart, and kidney health.

Key Takeaways:

  • A retrospective cohort study of adults with T2DM found that delaying SGLT2i therapy until HbA1c levels reach 9% may forfeit protection against dementia.
  • Earlier use of SGLT2is was associated with reduced risk of dementia, heart disease, and kidney disease in patients with T2DM.
  • The study analyzed data from 150 health systems worldwide, including the People's Hospital of Zhengzhou University.
  • Researchers found that patients with T2DM who initiated SGLT2i therapy between 2005 and 2025 had varying levels of protection against dementia, depending on their baseline HbA1c levels.
  • Delaying therapy until HbA1c levels increase to 9% may be too late to prevent cognitive decline and other health complications in patients with T2DM.
  • The study's findings suggest that healthcare providers should consider initiating SGLT2i therapy as soon as possible in patients with T2DM to maximize cognitive protection and overall health benefits.

Statistics:

  • The study analyzed data from 150 health systems worldwide, representing a total of 456,590 patients with T2DM.
  • Of the patients included in the study, 42.1% had a baseline HbA1c level 11%.
  • The study found that patients with T2DM who initiated SGLT2i therapy between 2005 and 2025 had a median age of 62.4 years (range: 45-85 years) and a median follow-up duration of 2.3 years (range: 1-6 years).
  • The study's researchers found that the risk of dementia increased by 12% for each unit increase in HbA1c levels (P < 0.01).

Sources:

  • Baseline HbA1c and dementia risk at SGLT2i initiation in type 2 diabetes. Diabetes, Obesity and Metabolism, 2025.
  • Wiley, 111 River St, Hoboken 07030-5774, NJ, USA.
  • Yangyang Wang, Dept. of Anesthesiology and Perioperative Medicine, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, People's Hospital of Henan Academy of Innovations in Medical Science, Zhengzhou, People's Republic of China.
  • NewsRx. New Type 2 Diabetes Findings from People's Hospital of Zhengzhou University Outlined (Baseline HbA1c and dementia risk at SGLT2i initiation in type 2 diabetes). Mental Health Weekly Digest. November 3, 2025; p 291.

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