One type of diabetes drug reduces dementia risk in older people

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In a study from the University of Toronto, scientists found a class of medication for type 2 diabetes may help older people with the condition reduce their risk of dementia.

They found that sodium-glucose cotransporter-2 (SGLT2) inhibitors are associated with a 20% lower dementia risk when compared to another kind of medication known as dipeptidyl peptidase-4 inhibitors (DPP4).

Often, the first medication prescribed to people with type 2 diabetes is metformin.

When metformin alone doesn’t have the desired effect, additional therapies such as SGLT2 and DPP4 inhibitors may be added or substituted. For many patients, physicians will choose between these two classes of drugs.

SGLT2 inhibitor medications, which include dapagliflozin and empagliflozin, are commonly prescribed. These drugs lower blood sugar by causing the kidneys to remove sugar from the body through urine.

DPP4 inhibitor medications—which include linagliptin, saxagliptin and sitagliptin—work by blocking the action of an enzyme that destroys an insulin-producing hormone.

In the study, the team found some diabetes medications, including the SGLT2 inhibitors, might manipulate the pathophysiology at an early stage before dementia develops.

They looked at more than 106,000 people aged 66 years and older.

To make their observations, the researchers examined Ontario health records for people who were newly prescribed one of either kind of medication and who hadn’t previously experienced dementia.

Then, they compared incidences of dementia between the two groups over a period of nearly three years.

Though scientists don’t fully understand why, diabetes is known to increase a person’s risk of dementia, including vascular dementia and Alzheimer’s disease, by as much as two times.

The most common types of dementia involve deposits of abnormally folded proteins, as well as metabolic and vascular changes, in the brain.

Diabetes is known to damage blood vessels throughout the body, especially the small vessels. The condition may also impair the brain’s smallest vessels.

The team next hopes to explore a newer class of diabetes drugs called glucagon-like peptide-1 receptor agonists. Those drugs also have shown some promise for having brain benefits.

If you care about dementia, please read studies that 7 healthy habits could help lower dementia risk for people with diabetes, and this antibiotic drug may effectively treat common dementia.

For more information about brain health, please see recent studies that high doses of common depression drug could temporarily switch off the brain, and results showing watch for these potential heart and brain problems after COVID-19.

The study was conducted by Walter Swardfager et al and published in the journal Diabetes Care.

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