A new type of diabetes drug may cut the risk of dementia risk in people with type 2 diabetes, a large-scale study has found.
Researchers also identified that the longer someone is on the drug, the greater the protection against dementia.
People with type 2 diabetes face a greater risk of developing dementia, and with dementia prevalence on the increase, researchers set out to shed more light on the protection different types of diabetes drugs offer.
The team focussed on one relatively new drug, sodium-glucose cotransporter-2 (SGLT-2) inhibitors, comparing it to dipeptidyl peptidase-4 (DPP-4) inhibitors in terms of reducing dementia risk.
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They found that taking SGLT-2 inhibitors was linked to a 35% lower risk of developing dementia in comparison to those on DPP-4 inhibitors.
Another key finding was that people who had been on SGLT-2 inhibitors for longer than two years saw the biggest reduction in risk.
The findings prompted the authors to conclude: “SGLT-2 inhibitors might prevent dementia, providing greater benefits with longer treatment.”
Aging brings greater risk of dementia, and with a growing older population, cases are on the rise.
However, type 2 diabetes has also been identified as a risk factor, with recent figures suggesting that the condition is associated with a 50% increase in the risk of developing dementia.
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Dr Raj Dasgupta, Associate Program Director of Internal Medicine Residency at Huntington Memorial Hospital, who was not involved in the study, explained: “People with type 2 diabetes have a higher risk of dementia because the same cardiovascular problems that increase the risk of type 2 diabetes also increase the risk of dementia.
“The main problem is that high blood sugar levels over time can damage blood vessels in the brain, leading to less blood and oxygen reaching brain cells.”
This can cause damage to the brain cells which can increase the risk of vascular dementia.
Insulin resistance, which is found in people with type 2 diabetes, also “affects brain cells and is linked to a higher chance of Alzheimer’s disease,” said Dr Dasgupta.
Other risk factors for dementia for people with type 2 diabetes include inflammation, oxidative stress, high blood pressure and obesity.
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SGLT-2 inhibitors work by stopping the kidneys from reabsorbing as much glucose, which means the body can get rid of glucose through urine rather than it re-entering the blood.
DPP-4 inhibitors, meanwhile, work by raising the body’s levels of glucagon-like peptide-1 (GLP-1), which boosts insulin production to reduce blood sugar levels.
The team of researchers used Korean National Health Insurance Service data for the period 2013 to 2021, which included 110,885 people with type 2 diabetes taking either SGLT-2 or DPP-4 inhibitors.
At follow-up – an average of 670 days – they found there were 1,172 new diagnoses of dementia within the group.
Read the study in full in The BMJ.
