Diabetes drug linked to reduced risk of dementia

Diabetes drug linked to reduced risk of dementia

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

According to the scientists, it could be worthwhile to prioritize these drugs for future repurposing research.

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

According to the researchers, these drugs can effectively prevent dementia in high-risk people with mild to moderate type 2 diabetes, and it may now be worth prioritizing them in future clinical trials to see if they can be reversed.

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

The researchers compared the incidence of dementia in older people with type 2 diabetes who received either a sulfonylurea or a thiazolidinedione (TZD) with those who received only metformin to shed more light on this.

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

Only elderly patients (aged at least 60 years) who received their first prescription for metformin, a sulfonylurea (tolbutamide, glimepiride, glipizide, or glyburide), or a TZD (rosiglitazone or pioglitazone) between January 2001 and December 2017 were included ( 65 ) (65 ) study. Their health was monitored for an average of almost 8 years.

After at least 1 year of drug treatment, use of TZDs alone was associated with a 22% lower risk of dementia of any cause, 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] with a high risk of dementia.”

Reference: “Use of oral diabetes medications and risk of incident dementia in US veterans aged ≥60 years with type 2 diabetes” 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 Open Diabetes Research & 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.

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