{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T22:22:09Z","timestamp":1791411729012,"version":"4.3.3"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2020,10,4]],"date-time":"2020-10-04T00:00:00Z","timestamp":1601769600000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"The Cure Parkinson's Trust","award":["LW011"],"award-info":[{"award-number":["LW011"]}]},{"DOI":"10.13039\/100008487","name":"Cure Parkinson\u2019s Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008487","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The elevated risk of Parkinson\u2019s disease in patients with diabetes might be mitigated depending on the type of drugs prescribed to treat diabetes. Population data for risk of Parkinson\u2019s disease in users of the newer types of drugs used in diabetes are scarce. We compared the risk of Parkinson\u2019s disease in patients with diabetes exposed to thiazolidinediones (glitazones), glucagon-like peptide-1 (GLP-1) receptor agonists and dipeptidyl peptidase 4 (DPP4) inhibitors, with the risk of Parkinson\u2019s disease of users of any other oral glucose lowering drugs. A population-based, longitudinal, cohort study was conducted using historic primary care data from The Health Improvement Network. Patients with a diagnosis of diabetes and a minimum of two prescriptions for diabetes medications between January 2006 and January 2019 were included in our study. The primary outcome was the first recording of a diagnosis of Parkinson\u2019s disease after the index date, identified from clinical records. We compared the risk of Parkinson\u2019s disease in individuals treated with glitazones or DPP4 inhibitors and\/or GLP-1 receptor agonists to individuals treated with other antidiabetic agents using a Cox regression with inverse probability of treatment weighting based on propensity scores. Results were analysed separately for insulin users. Among 100\u2009288 patients [mean age 62.8 years (standard deviation 12.6)], 329 (0.3%) were diagnosed with Parkinson\u2019s disease during the median follow-up of 3.33 years. The incidence of Parkinson\u2019s disease was 8 per 10\u2009000 person-years in 21\u2009175 patients using glitazones, 5 per 10\u2009000 person-years in 36\u2009897 patients using DPP4 inhibitors and 4 per 10\u2009000 person-years in 10\u2009684 using GLP-1 mimetics, 6861 of whom were prescribed GTZ and\/or DPP4 inhibitors prior to using GLP-1 mimetics. Compared with the incidence of Parkinson\u2019s disease in the comparison group (10 per 10\u2009000 person-years), adjusted results showed no evidence of any association between the use of glitazones and Parkinson\u2019s disease [incidence rate ratio (IRR) 1.17; 95% confidence interval (CI) 0.76\u20131.63; P\u2009=\u20090.467], but there was strong evidence of an inverse association between use of DPP4 inhibitors and GLP-1 mimetics and the onset of Parkinson\u2019s disease (IRR 0.64; 95% CI 0.43\u20130.88; P\u2009&amp;lt;\u20090.01 and IRR 0.38; 95% CI 0.17\u20130.60; P\u2009&amp;lt;\u20090.01, respectively). Results for insulin users were in the same direction, but the overall size of this group was small. The incidence of Parkinson\u2019s disease in patients diagnosed with diabetes varies substantially depending on the treatment for diabetes received. The use of DPP4 inhibitors and\/or GLP-1 mimetics is associated with a lower rate of Parkinson\u2019s disease compared to the use of other oral antidiabetic drugs.<\/jats:p>","DOI":"10.1093\/brain\/awaa262","type":"journal-article","created":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T15:10:53Z","timestamp":1594998653000},"page":"3067-3076","source":"Crossref","is-referenced-by-count":233,"title":["Diabetes medications and risk of Parkinson\u2019s disease: a cohort study of patients with diabetes"],"prefix":"10.1093","volume":"143","author":[{"given":"Ruth","family":"Brauer","sequence":"first","affiliation":[{"name":"Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8840-7267","authenticated-orcid":false,"given":"Li","family":"Wei","sequence":"additional","affiliation":[{"name":"Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiantian","family":"Ma","sequence":"additional","affiliation":[{"name":"Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilan","family":"Athauda","sequence":"additional","affiliation":[{"name":"Department of Clinical and Movement Neurosciences, UCL Institute of Neurology, Queen Square, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Girges","sequence":"additional","affiliation":[{"name":"Department of Clinical and Movement Neurosciences, UCL Institute of Neurology, Queen Square, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9671-0212","authenticated-orcid":false,"given":"Nirosen","family":"Vijiaratnam","sequence":"additional","affiliation":[{"name":"Department of Clinical and Movement Neurosciences, UCL Institute of Neurology, Queen Square, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Auld","sequence":"additional","affiliation":[{"name":"Department of Clinical and Movement Neurosciences, UCL Institute of Neurology, Queen Square, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cate","family":"Whittlesea","sequence":"additional","affiliation":[{"name":"Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Wong","sequence":"additional","affiliation":[{"name":"Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK"},{"name":"Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Foltynie","sequence":"additional","affiliation":[{"name":"Department of Clinical and Movement Neurosciences, UCL Institute of Neurology, Queen Square, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,10,4]]},"reference":[{"key":"2021010902104378400_awaa262-B1","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.pneurobio.2016.10.001","article-title":"Insulin resistance and Parkinson's disease: a new target for disease modification?","volume":"145\u2013146","author":"Athauda","year":"2016","journal-title":"Prog 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