OBJECTIVES: Several studies have suggested that antidiabetic drugs could be effective in preventing the development of Parkinson’s disease (PD). However, there are no consistent reports on the prevention of PD according to the type of antidiabetic medication. In this study we aimed to investigate the effect of the antidiabetic drug on the development of PD.

METHODS: We conducted a nationwide case-control study using the Korean Health Insurance Review and Assessment database. Elderly patients (aged ≥ 60years) who had been diagnosed with type 2 diabetes mellitus between January 1, 2009, and December 31, 2017, were recruited in this study. A 1-year lag time was applied for minimize the reverse causal relationship of PD. The association between the use of antidiabetic drugs and the incidence of PD was determined by Cox proportional hazard regression analyses. The results were adjusted for age, sex, insurance type, comorbidities, and use of concurrent medications.

RESULTS: A total of 85,657 subjects were identified for this study, of which 1,224 individuals were identified as PD case group and 84,433 were included in the control group. After 1:1 propensity score matching, a total of 1,308 cases were present in each of the groups with and without PD. The results demonstrated that the use of DPP-4 inhibitors was associated with a lower risk of occurrence of PD (adjusted hazard ratio [aHR] 0.68; 95% confidence interval [CI]: 0.57-0.83). However, a statistically significant association was not observed in the use of metformin, sulfonylureas, and thiazolidinedione.

CONCLUSIONS: This study demonstrated that the use of DPP-4 inhibitors could be associated with a reduced risk of occurrence of PD.