Evidence map›Paper›PMID 30487973›Full record

ArticleBMJ open diabetes research & care2018

Impact of pharmacological treatment of diabetes mellitus on dementia risk: systematic review and meta-analysis.

Jacqueline M McMillan, Bria S Mele, David B Hogan, Alexander A Leung

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open diabetes research & care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 6 pooled it
4.4field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 6 syntheses or guidelines pooled it, 76 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Diabetes-Associated Cognitive Impairment: Pathophysiology and Emerging Therapies.Annals of clinical and translational neurology · 2026
    Review
  8. Article
  9. Article
  10. Article
  11. The Impact of Cognitive Impairment on Cardiovascular Disease.Journal of the American College of Cardiology · 2025
    Review
  12. Article
  13. Review
  14. Article
  15. Article
  16. Article
  17. Article
  18. Dementia in Diabetes: The Role of Hypoglycemia.International journal of molecular sciences · 2023
    Review
  19. Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Jacqueline M McMillanDepartment of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.ORCID 0000-0002-7090-9485
Bria S MeleDepartment of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
David B HoganDepartment of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.
Alexander A LeungDepartment of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.
University of Calgary · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe association between diabetes mellitus (DM) treatment and dementia is not well understood.

objectiveTo investigate the association between treatment of diabetes, hypoglycemia, and dementia risk. RESEARCH DESIGN AND

methodsWe performed a systematic review and meta-analysis of pharmacological treatment of diabetes and incident or progressive cognitive impairment. We searched Ovid MEDLINE, Embase, Cochrane Central Registry of Controlled Trials, and PsychINFO from inception to 18 October 2017. We included cross-sectional, case-control, cohort, and randomized controlled studies. The study was registered with PROSPERO (ID CRD42017077953).

resultsWe included 37 studies into our systematic review and 13 into our meta-analysis. Ten studies investigated any antidiabetic treatment compared with no treatment or as add-on therapy to prior care. Treatment with an antidiabetic agent, in general, was not associated with incident dementia (risk ratio (RR) 1.01; 95% CI 0.93 to 1.10). However, we found differential effects across drug classes, with a signal of harm associated with insulin therapy (RR 1.21; 95% CI 1.06 to 1.39), but potentially protective effects with thiazolidinedione exposure (RR 0.71; 95% CI 0.55 to 0.93). Severe hypoglycemic episodes were associated with a nearly twofold increased likelihood of incident dementia (RR 1.77; 95% CI 1.35 to 2.33). Most studies did not account for DM duration or severity. CONCLUSIONS AND LIMITATIONS: The association between treatment for diabetes and dementia is differential according to drug class, which is potentially mediated by hypoglycemic risk. Not accounting for DM duration and/or severity is a major limitation in the available evidence base.

Indexed as

dementiadiabetes mellitusmild cognitive impairmenttreatment

Identifiers

PMID30487973
PMCPMC6254737
OpenAlexW2900724835

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.