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Type 2 diabetes mellitus has been associated with an increased risk of cognitive decline and dementia, with patients being 1.5–2 times more likely to develop these conditions. While both sodium-glucose co-transporter 2 (SGLT2) inhibitors and thiazolidinediones (TZDs) have shown potential neuroprotective effects in previous studies, their comparative effectiveness for preventing neurodegenerative outcomes has not been established. This study aimed to compare the risk of stroke, dementia and Alzheimer’s disease (AD) between patients treated with SGLT2 inhibitors and those treated with TZDs.
Multicentre, retrospective, observational, new-user, active-comparator cohort study.
Electronic health record-based databases from 11 secondary and tertiary institutions in South Korea from 1 January 2014 to 31 July 2025. The study period began in 2014, following the post-marketing surveillance initiation of SGLT2 inhibitors in Korea (November 2013), to ensure adequate drug availability and clinical adoption.
Patients aged 40 years or older who were newly prescribed either SGLT2 inhibitors or TZDs without prior exposure.
Propensity score matching (1:1) was performed using sex as the primary covariate due to data availability constraints in the Observational Medical Outcomes Partnership Common Data Model framework. The HRs with 95% CIs were measured via Cox regression analysis.
The study analysed 24 172 matched pairs for stroke outcomes (40 483 person-years in the SGLT2 inhibitor group and 39 363 person-years in the TZD group), 25 111 matched pairs for dementia (41 924 person-years in the SGLT2 inhibitor group and 40 726 person-years in the TZD group) and 25 237 matched pairs for AD (42 139 person-years in the SGLT2 inhibitor group and 40 895 person-years in the TZD group) across 11 participating hospitals. After a 1:1 propensity score matching, the SGLT2 inhibitors showed no significant difference in stroke risk (HR 1.18, 95% CI 0.62 to 2.23, p=0.62), while having significant reductions in dementia risk (HR 0.66, 95% CI 0.45 to 0.98, p=0.04) and AD risk (HR 0.54, 95% CI 0.35 to 0.83, p=0.005). Moreover, these protective effects for neurodegenerative outcomes were shown to be consistent across multiple hospital sites.
SGLT2 inhibitors are associated with a reduced risk of dementia and AD compared with TZDs in patients aged 40 years or older with type 2 diabetes and have neutral effects on stroke risk. These findings confirm the potential selective neuroprotective benefits of SGLT2 inhibitors for neurodegenerative outcomes, which may inform therapeutic decision-making for diabetic patients at risk of cognitive decline.
To explore the experiences of nurse leaders and managers in planning the hospital nursing workforce in accordance with the government-led response to the COVID-19 pandemic in South Korea.
Descriptive, qualitative study.
Semistructured interviews were conducted with 10 participants at three general hospitals in Seoul and Gyeonggi Province from August to October 2022. Eligible participants were nurse leaders and managers who were involved in decision making and management of the nursing workforce for the COVID-19 response or who served on a COVID-19 response team at each study hospital. Data were analysed using inductive content analysis.
Four main themes emerged from the interview data, each with subthemes: exacerbated inherent vulnerabilities, highlighting existing nursing shortages and financial constraints; delay to systematic response, with frequent government ad-hoc orders increasing disruptions to on-site operations and inefficiencies of the external workforce; creation of new conflicts, including those related to nursing staff deployment and compensation gaps and demands on new leadership, with the need for effective crisis management and visionary leadership.
The results indicate that nurse leaders and managers face unexpected challenges in effectively planning their nursing workforce during the pandemic. These challenges are further compounded by centralised ad-hoc government orders that prioritise the urgent demands of COVID-19 patient care, often overlooking the unique needs and circumstances of individual hospitals.
There is a need for more flexible and localised workforce planning strategies to better support nurse leaders and managers. Furthermore, ongoing collaboration between healthcare leaders and policymakers is crucial to address the disconnect between centralised government-led responses and hospital-specific needs, which could enhance the resilience of the nursing workforce and improve disaster and emergency preparedness in the future.
COREQ checklist was used.
No patient or public contribution. Data were obtained from healthcare professionals.
Despite substantial research investments aiming to prevent cancer and develop therapeutic interventions, cancer remains a formidable challenge. In view of the persistent rise in cancer prevalence, the condition should also be recognised as a chronic disease. Such an approach can enhance the quality of life of patients with cancer, inhibit treatment-related adverse events and prevent recurrence via comprehensive post-treatment management. The core objective of this study is to investigate the association between dietary factors and treatment-related adverse events in patients with cancer, with the aim of providing individualised dietary recommendations to reduce adverse events and enhance quality of life.
The study cohort will include 600 participants aged ≥20 years. The participants will be assessed for dietary intake, cancer therapy-related adverse events and single-nucleotide polymorphisms using genomic DNA extracted from saliva. In addition, general and clinical information, lifestyle patterns and general/biochemical data of the blood will also be collected. The primary outcome is dietary factors that mitigate chemotherapeutic adverse events, and the secondary outcome is the association between nutritional status and survival in Korean patients with cancer. Considering the potential impact of dietary habits on the adverse events of cancer treatment, the findings of this study can be used as a basis for the establishment of new dietary guidelines for patients with cancer.
The Institutional Review Board of Severance Hospital, Yonsei University Health System, Seoul, Korea, approved the study protocol (4-2021-1110). Further, all participants provided a written informed consent prior to the study. The findings will be shared via publications.
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