SHBC1349

S..LOW¹, S.F.ANG¹, A.MOH¹, K.ANG¹, T.SUBRAMANIAM², C.F.SUM², S.C.LIM¹

Khoo Teck Puat Hospital¹, Admiralty Medical Centre²

Sodium-glucose cotransporter-2 inhibitors(SGLT2i) reduce risk of cardiovascular and renal failure. Recent mouse models showed promising results of SGLT2i in ameliorating Type 2 Diabetes(T2D)-induced ultrastructural remodeling of neurovascular unit and neuroglia. Hitherto, there is no published study on association between SGLT2i use and cognitive function in patients with T2D.

This was a prospective cohort study of 428 patients from SMART2D cohort over period of up to 6.4 years. Data on SGLT2i use was derived from questionnaire and verified with clinical database. Cognition was assessed with Repeatable Battery for the Assessment of Neuropsychological Status(RBANS) on five domains –immediate memory, delayed memory, visuo-spatial/construction, language and attention. Multiple linear regression was performed to examine association between SGLT2i use and rate of RBANS score change, adjusting for demographics, education, clinical covariates, baseline RBANS score and presence of APOE ε4 allele.

The participants’ mean age was 61.1 ± 6.8 years. There were 165 patients(38.6%) using SGLT2i – 115(26.9%) for <5 years and 50(11.7%) for ≥5 years. In unadjusted analysis, ≥5 years SGLTi use was positively associated with change in RBANS score in memory(coefficient 3.117;95%CI0.552-5.683;p=0.017) when compared with no SGLTi use. This positive association persisted in fully adjusted model(coefficient 3.108;95%CI 0.274-5.943;p=0.032). ≥5 years SGLTi use was also positively associated with change in score in language (coefficient 3.786;95%CI 0.287-7.284; p=0.034).

Our findings have revealed previously unobserved association between long-term SGLT2i use and improved cognitive scores in immediate memory and language domains This may pave the way for future studies on the role of SGLT2i in ameliorating cognitive decline.