Metformin is a very old medication… so I think its considered “first generation”, or “first line” as it was probably the first major medication for diabetes, and the most commonly used medication for diabetes.
The SGLT2 inhibitors are newer, coming on the market a decade ago or so, so they are considered second-line medications in the treatment of diabetes.
It sounds like the SGLT2 inhibitors are the best option, with better performance than metformin (in the elderly). There may be a study of these medicines in people over the age of 60 to 75 (a younger cohort) that I’m not aware of, but I haven’t looked.
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vongehr
#64
So “Metformin displayed the lowest risk of dementia across diverse antidiabetics,” refers to first line ones only?
I thought first line “of defense” is given first to a patient, like telmisartan before amlopidine, or metformin before SGLT2i still is today.
I’m not sure where you’re getting that quote from - can you link to the paper you’re quoting?
vongehr
#66
It is just one sentence above the first quote. That is why I am confused.
" Metformin displayed the lowest risk of dementia across diverse antidiabetics, whereas α-glucosidase inhibitors demonstrated the highest risk . SGLT2i exhibited the lowest dementia risk across second-line antidiabetics. Dementia risk was significantly higher with dipeptidyl peptidase-4 inhibitor (DPP4i), metformin,…"
