COMPARISON OF DIFFERENT CLASSES OF ORAL ANTIDIABETIC DRUGS IN COMBINATION WITH METFORMIN ON COGNITIVE FUNCTIONS

Type 2 diabetes mellitus is associated with cognitive impairment. The antidiabetic treatment found to delays the impairment. However, the benefit is due to antidiabetic drugs, or control of blood sugar is debatable. Most of the drug-based studies used monotherapy, which contradicts the clinical practice. This study aims to assess cognitive function in type-2 diabetes mellitus patients on metformin and other oral hypoglycaemic agent combination treatment. The cross-sectional study included 325 type 2 diabetes patients based on inclusion and exclusion criteria. They were categorized based on a combination of oral antidiabetics. Socio-demographic and medication data were obtained using medical records and personal interviews. Mini-Mental State Examination Scale- Tamil version (MMSE) was applied to measure the cognitive functions. Aged patients showed a reduced MMSE score of 18.18 ± 1.34. Increased duration of diabetes, >15 years, had the least MMSE score of 21.36 ± 1.37. Metformin-DPP-IV inhibitors combination found to benefit the cognition MMSE score = 29.11 ± 0.19 (P<0.001), compared to alpha glucosidase-metformin and thiazolidinedione- metformin combinations. A similar observation was found in individual domains of cognition as well. Education found to be protective of cognitive impairment. The stability in the blood glucose control and inherent mechanisms of sitagliptin might help in delaying cognitive impairment among type 2 diabetes. Sitagliptin- Metformin combination found to have better cognitive scores compared to other metformin-oral antidiabetic combinations.