Recent research published in The BMJ indicates that sodium-glucose cotransporter-2 (SGLT-2) inhibitors, a class of diabetes medication, may significantly reduce the risk of dementia in individuals with type 2 diabetes. The study found that SGLT-2 inhibitors are associated with a 35% lower risk of developing dementia compared to other common diabetes treatments.
The study highlights that the protective effect of SGLT-2 inhibitors increases with the duration of use. Longer use of these drugs corresponds with a greater reduction in dementia risk. This new evidence is promising amid rising dementia prevalence globally, though researchers call for additional studies to validate these findings.
Link Between Type 2 Diabetes and Dementia
Type 2 diabetes is known to elevate the risk of developing dementia by 50%, a significant concern as both conditions become increasingly prevalent. Aging, a primary risk factor for dementia, is compounded by type 2 diabetes, which can exacerbate cardiovascular problems that contribute to cognitive decline.
Dr. Raj Dasgupta, chief medical advisor for Fortune Recommends Health, explains that chronic high blood sugar levels from diabetes can damage brain blood vessels, leading to reduced blood and oxygen flow to brain cells. This damage can result in cognitive decline and increase the risk of vascular dementia, which is related to impaired blood supply to the brain. Insulin resistance, a hallmark of type 2 diabetes, is also linked to a higher likelihood of Alzheimer’s disease.
Understanding SGLT-2 Inhibitors
Approved in the U.S. in 2014, SGLT-2 inhibitors, such as dapagliflozin (Farxiga), help manage type 2 diabetes by preventing glucose reabsorption in the kidneys, allowing excess glucose to be excreted in urine. Other SGLT-2 inhibitors include canagliflozin (Invokana), empagliflozin (Jardiance), and ertugliflozin (Steglatro).
These drugs are increasingly prescribed to manage diabetes when other medications are insufficient. Emerging research suggests they may also offer benefits beyond diabetes management, including potentially reducing dementia risk.
Study Comparison and Findings
The recent study compared the effects of SGLT-2 inhibitors with dipeptidyl peptidase-4 (DPP-4) inhibitors, another class of diabetes drugs. DPP-4 inhibitors work by increasing insulin production through the glucagon-like peptide-1 (GLP-1) pathway.
Researchers analyzed data from the Korean National Health Insurance Service covering 110,885 individuals with type 2 diabetes who used either SGLT-2 or DPP-4 inhibitors between 2013 and 2021. The study, which followed participants for an average of 670 days, found 1,172 new dementia diagnoses.
Those using SGLT-2 inhibitors had a 35% lower risk of developing dementia compared to those using DPP-4 inhibitors. The risk reduction was more pronounced for vascular dementia (52%) and Alzheimer’s disease (39%). Longer duration of SGLT-2 inhibitor use was associated with greater risk reduction.
Implications and Future Research
While the study’s observational nature suggests that the reported effects could be overestimated, the large sample size and clear results across various subgroups provide robust evidence. The authors advocate for randomized controlled trials to further substantiate these findings.
Reducing Dementia Risk for Diabetics
Dr. Akhil Shenoy, an endocrinologist, advises that managing diabetes through normalizing blood pressure and blood sugar levels, maintaining a healthy weight, and engaging in regular physical activity can reduce dementia risk. Avoiding tobacco is also crucial.
Registered dietitian Angel Luk recommends reducing alcohol intake, increasing fiber-rich foods, and managing stress to lower dementia risk. Dr. Clifford Segil emphasizes that monitoring glucose levels and adhering to prescribed medications can prevent complications, including dementia.
If future research confirms these findings, SGLT-2 inhibitors could become a valuable tool in addressing the growing dementia epidemic. Managing diabetes effectively and adopting a healthy lifestyle are critical steps in reducing dementia risk.
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