Neuropsychiatric and neurocognitive outcomes of metformin versus insulin therapy in Egyptian patients with type 2 diabetes: focus on NGF and BDNF; a cross-sectional study
Abstract
Type 2 diabetes mellitus (T2DM) and antidiabetic therapy may influence brain health and mood through neurotrophic and psychological pathways. This study compared the effects of metformin versus insulin on cognitive performance, neurotrophic factors, and mood in Egyptian patients with T2DM. This cross-sectional study included 200 T2DM patients aged ≥ 50 years, divided equally into metformin and insulin-treated groups. Cognitive status was assessed using the Mini-Addenbrooke’s Cognitive Examination (Mini-ACE). Serum brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) were measured. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). Multiple linear regressions identified independent predictors of cognition, depression, and anxiety. Cognitive impairment was present in 35.5% of participants (16% MCI, 19.5% dementia), with a markedly higher prevalence in the insulin group (61%) than in the metformin group (10%), Metformin-treated patients had higher Mini-ACE scores and elevated serum BDNF and NGF. Mean anxiety and depression scores were statistically higher in the insulin group than in the metformin group, with more insulin-treated patients in the moderate-to-severe categories. Regression confirmed depression was driven by anxiety (β = 0.953, p < 0.001), while anxiety was influenced by depression, lower BDNF, and insulin therapy. Due to the cross-sectional design, causality cannot be inferred. However, T2DM was…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 200 participants or records.
Read the paper
Related studies
- Metformin as an adjuvant in breast cancer treatment
- Metformin Lysosomal Targeting: A Novel Aspect to Be Investigated for Metformin Repurposing in Neurodegenerative Diseases?
- Aberrant HSF1 signaling activation underlies metformin amelioration of myocardial infarction in mice
- Metformin induces ZFP36 by mTORC1 inhibition in cervical cancer-derived cell lines
- Protein Interaction Network for Identifying Vascular Response of Metformin (Oral Antidiabetic)
- Preventing Long COVID With Metformin
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.