- Type 2 diabetes is associated with an increased risk of Alzheimer’s and Parkinson’s disease.
- New research suggests that certain diabetes medications may significantly reduce this risk.
- These drugs are gliflozin or SGLT2 Inhibitors prevent the kidneys from reabsorbing excess blood sugar, improving blood sugar levels.
- Although the findings are promising, the authors urge that further studies are needed to confirm their findings.
A team of scientists from South Korea recently investigated a group of diabetes medications called gliflozins, or sodium-glucose cotransporter 2 (SGLT2) inhibitors.
They wanted to understand whether these drugs could reduce the risk of neurodegenerative disease in people with type 2 diabetes (T2D).
The analysis found that compared with people taking other diabetes medications, people taking gliflozin had the following characteristics:
- 19% lower chance of developing Alzheimer's disease
- 20% lower chance of developing Parkinson's disease
- 31% lower chance of developing vascular dementia
This study Neurology September 18th.
“The results remained largely consistent even after adjusting for factors such as blood pressure, blood glucose levels, cholesterol and kidney function,” the study authors said. Minyoung Lee, MDA professor at the Yonsei University School of Medicine in South Korea said, News Release.
For the study, researchers accessed data on 358,862 people with type 2 diabetes who were followed for an average of 9.6 years.
By the end of the study, 6,837 participants had developed dementia or Parkinson's disease.
Overall, gliflozin use was associated with a 22% lower risk of developing dementia or Parkinson's disease.
When the researchers analyzed the risk of specific neurodegenerative diseases, they found a 19% reduced risk of Alzheimer's disease, a 20% reduced risk of Parkinson's disease, and a 31% reduced risk of vascular dementia.
Daniel Truong, MDis a neurologist and medical director of the Truong Neuroscience Institute at MemorialCare Orange Coast Medical Center in Fountain Valley, California. Journal of Clinical Parkinson's and Related Disordersshared his thoughts on the study findings with Healthline.
Truong said he was surprised to see that the effect was “consistent across different patient subgroups, including those with different comorbidities such as cardiovascular disease and hypertension.” Truong was not involved in the study.
Gliflozin, or SGLT2 inhibitors, work by preventing the kidneys from reabsorbing large amounts of glucose, allowing the body to excrete glucose in the urine rather than allowing it to re-enter the blood.
SGLT2 inhibitors are considered second-line medications, meaning doctors tend to prescribe them when your current diabetes medication isn't working well enough.
Recently, there has been growing interest in this class of drugs and their protective effects against neurodegenerative diseases.
For example, another South Korean study published last month found that taking gliflozin
The latest study took a similar approach, but also investigated the effect of gliflozin on Parkinson's disease.
In addition, the scientists compared gliflozin with a range of other diabetes medications, rather than the single drug they compared in the previous study.
However, in type 2 diabetes, insulin resistance can develop, which means that cells no longer respond properly to insulin and are unable to take up glucose efficiently.
The evidence is mounting Brain insulin resistance It plays an important role in neurodegenerative diseases: elevated blood sugar levels can damage sensitive brain cells.
Recent
Similarly, people with type 2 diabetes
“A proper response to insulin is important not only for the pancreas and many organs of the body, but also for the brain,” he explained. Alvaro Pascual Leone, MDPascual Leone, a professor of neurology at Harvard Medical School and chief medical officer and co-founder of Linus Health, was not involved in the study.
“Insulin resistance may play an important role in the link between type 2 diabetes and Alzheimer's disease as well as other causes of dementia,” he told Healthline.
As the prevalence of diabetes increases, more people may be at increased risk of developing neurodegenerative diseases as they age.
The study authors suggest that gliflozin may only slow neurodegeneration rather than halting it entirely, but it could still provide significant benefit to the elderly population.
Still, the study has some limitations. The researchers note that these neurodegenerative diseases take years to develop, so people who don't develop dementia or Parkinson's disease during the study period may still develop the condition later in life.
“Further studies are needed to verify the long-term validity of these findings,” Lee said.
The study also leaves several questions unanswered.
For example, the authors suspect that starting treatment with gliflozin earlier may further reduce the risk of neurodegeneration, which may be another reason why it's best to start treatment as early as possible.
The researchers also found that combining metformin with gliflozin reduced the risk of Parkinson's disease and dementia more than any other drug combination.
This raises the enticing possibility that drug combinations might be even more effective.
“To optimize the use of antidiabetic drugs in clinical practice for neurodegenerative diseases, future studies should [gliflozins] with a variety of combination therapies,” the authors wrote.
It is currently unknown whether gliflozin can also reduce the risk of neurodegenerative disease in people without type 2 diabetes.
“Further research is needed to determine whether gliflozin has neuroprotective effects, can improve brain health and reduce dementia in people without diabetes,” he explained. Clifford Seguill“These findings are a major contributing factor to the study,” said Dr. Schneider, a neurologist at Providence Saint John's Health Center in Santa Monica, California, who was not involved in the study.
“With widespread adoption, we should know within 10 years whether this is true or not,” Segal added. “We may know the answer by 2035.”
Truong noted that these drugs “could form the basis of future anti-dementia drugs, especially for people at high risk of developing dementia.”
“Its ability to improve brain metabolism, reduce inflammation and protect cardiovascular health is consistent with major risk factors and mechanisms that lead to dementia,” he continued.
“These significant benefits in reducing the risk of dementia and neurodegenerative disease represent a groundbreaking advance in diabetes care with broad implications for public health,” Truong concluded.
