Diabetes drug linked to lower risk of dementia

Brain Boost Mental Focus Clarity Concept

These drugs can successfully prevent dementia in high-risk people with mild or moderate type 2 diabetes.

According to the scientists, it might be worth prioritizing these drugs for future repurposing research.

According to a long-term study recently published in the open access journal BMJ Research and open diabetes care, use of the diabetes drug glitazones is associated with a 22% lower risk of dementia. Glitazones are often known as thiazolidinediones or TZDs for short and are an older class of type 2 diabetes medications.

These drugs can effectively prevent dementia in high-risk people with mild to moderate type 2 diabetes, the researchers say, and may now be worth prioritizing in future clinical trials to determine if they can be reused.

Researchers have begun to investigate whether diabetes medications could help prevent or cure dementia, since type 2 diabetes and dementia share several physiological patterns. However, the results have been inconsistent so far.

The researchers compared the incidence of dementia in older adults with type 2 diabetes taking sulfonylureas or thiazolidinedione (TZDs) with those taking metformin alone to shed more light on this.

They used data from 559,106 people with type 2 diabetes who had been diagnosed in the Veterans Affairs (VA) National Health System between January 2000 and December 2019.

Only older patients (at least 60 years of age) and who received a first prescription of metformin, a sulfonylurea (tolbutamide, glimepiride, glipizide, or glyburide) or a TZD (rosiglitazone or pioglitazone) between January 2001 (559,106) were included in the study. and December 2017 (559,106). the study. His health was tracked for an average of almost 8 years.

After at least 1 year of drug treatment, use of a TZD alone was associated with a 22% lower risk of all-cause dementia compared with use of metformin alone.

Specifically, it was associated with an 11% lower risk of[{” attribute=””>Alzheimer’s disease and a 57% lower risk of vascular dementia. Given that vascular diseases increase the risk of Alzheimer’s disease, TZDs may also help to reduce dementia and Alzheimer’s disease in part through their favorable effects on the vascular system, say the researchers.

While the risk of dementia from any cause was 11% lower for the use of metformin and TZD combined, it was 12% higher for the use of a sulfonylurea drug alone, prompting the researchers to suggest that supplementing a sulfonylurea with either metformin or a TZD may partially offset these effects.

Further in-depth analysis indicated that those younger than 75 benefited more from a TZD than older patients, highlighting the importance of early prevention for dementia, note the researchers. And these drugs also seemed to be more protective in overweight or obese patients.

This is an observational study, so definitive conclusions can’t be drawn about cause and effect. And the researchers acknowledge that certain potentially influential information wasn’t available, including kidney function and genetic factors, and that study participants were predominantly male and White.

But they suggest that future studies for repurposing diabetes drugs for dementia prevention might want to consider prioritizing TZDs, based on their findings.

And they conclude: “These findings may help inform medication selection for [older] patients with [type 2 diabetes] at high risk of dementia.”

Reference: “Use of oral diabetes medications and the risk of incident dementia in US veterans ≥60 years with type 2 diabetes” by Xin Tang, Roberta Diaz Brinton, Zhao Chen, Leslie V. Farland, Yann Klimentidis, Raymond Migrino, Peter Reaven, Kathleen Rodgers, and Jin J Zhou, October 11, 2022, BMJ Research and open diabetes care.
DOI: 10.1136/bmjdrc-2022-002894

The study was funded by the National Human Genome Research Institute, the National Science Foundation, the National Institute of Diabetes and Digestive and Kidney Diseases, and the National Heart, Lung, and Blood Institute.

Leave a Comment