A recent study published in The BMJ suggests that a relatively new diabetes drug known as sodium-glucose cotransporter-2 (SGLT-2) inhibitors may reduce the risk of developing dementia in people with type 2 diabetes. The study found that taking SGLT-2 inhibitors was associated with a 35% lower risk of developing dementia compared to taking another common diabetes drug with a different mechanism. The longer an individual had been taking the drug, the greater the protective effect was. Researchers conducted a large-scale observational study using data from the Korean National Health Insurance Service to investigate the link between SGLT-2 inhibitors and dementia risk in people with type 2 diabetes.
The primary risk factor for dementia is aging, and as the average age of the population increases, so does the number of dementia cases. Developing type 2 diabetes is linked to a 50% increase in the risk of developing dementia. People with type 2 diabetes are at a higher risk of dementia due to cardiovascular problems that increase the risk of both conditions, as high blood sugar levels over time can damage blood vessels in the brain, leading to cognitive decline and an increased risk of vascular dementia. Insulin resistance, which is a hallmark of type 2 diabetes, also affects brain cells and is linked to a higher chance of Alzheimer’s disease.
SGLT-2 inhibitors are relatively new drugs that treat type 2 diabetes by preventing the kidneys from reabsorbing as much glucose, allowing the body to remove glucose in urine rather than it re-entering the blood. Currently, around 1 in 10 people in the U.S. with type 2 diabetes take these medications. The study compared people taking SGLT-2 inhibitors with those taking dipeptidyl peptidase-4 (DPP-4) inhibitors and found that participants on SGLT-2 inhibitors had a 35% reduced risk of developing dementia. The risk reduction was most pronounced in those who had been taking SGLT-2 inhibitors for longer periods of more than 2 years compared to less than 2 years.
The authors of the study suggest that SGLT-2 inhibitors might prevent dementia, providing greater benefits with longer treatment. While the effect size may be overestimated due to the observational nature of the study, the results were clear in all subgroups, indicating that the findings are relatively robust. The authors call for randomized controlled trials to confirm the findings. Managing diabetes with medication, maintaining normal blood pressure and blood sugar levels, a healthy body weight, and engaging in physical activity can help reduce the risk of developing dementia in people with type 2 diabetes. Dietary interventions such as reducing alcohol intake and consuming more fiber-rich foods may also reduce risk.
In conclusion, SGLT-2 inhibitors may offer a new potential treatment option for people with type 2 diabetes who are at an increased risk of developing dementia. Future research confirming these findings could help stem the dementia epidemic, especially as the prevalence of both type 2 diabetes and dementia continues to rise. Managing diabetes with medication and making healthy lifestyle changes could significantly reduce a person’s risk of developing dementia, emphasizing the importance of proactive healthcare for individuals with type 2 diabetes.
