• Posted July 15, 2024

Some Diabetes Drugs May Lower Dementia Risk

Some diabetes drugs appear to lower the risk that people with type 2 diabetes will develop dementia or Alzheimer’s disease, a new evidence review says.

The risk of dementia and Alzheimer’s is significantly lower in patients treated with metformin or a class of meds called "sodium glucose co-transporter-2 (SGLT-2) inhibitors", compared with other diabetes drugs, researchers report.

Type 2 diabetes affects about 530 million people around the world, and there’s at least a 50% increased risk of cognitive impairment and dementia in these people, researchers said in background notes.

“Our study contributes to the existing evidence by suggesting potential additional benefits of SGLT-2 inhibitors in mitigating dementia risk, thereby providing significant clinical implications for diabetes management,” lead researcher Yeo Jin Choi at Kyung Hee University in Seoul, South Korea, said in a news release.

“Elderly patients aged 75 years or older may particularly benefit from these findings, since they often face greater cognitive health concerns,” Choi added.

For their review, researchers analyzed data from 16 prior studies involving more than 1.5 million patients. The studies looked at six diabetic drug classes: DPP4 inhibitors, metformin, SGLT-2 inhibitors, sulfonylureas, alpha-glucosidase inhibitors and thiazolidinediones.

The lowest risk of dementia and Alzheimer’s was found in patients taking metformin, results show.

But SGLT-2 inhibitors were also associated with a lower risk of cognitive decline as well, and also provided heart health benefits, researchers said. These drugs include Farxiga (dapagliflozin) and Jardiance (empagliflozin).

What's more, results show that SGLT-2 inhibitors performed better than all other drugs, including metformin, in reducing dementia risk in patients 75 and older.

“We were quite surprised by the study results, particularly the potential cognitive benefits of SGLT-2 inhibitors over metformin and DPP-4 inhibitors in patients aged 75 years or older,” Choi said. “This finding is particularly notable given that SGLT-2 inhibitors are currently used for heart failure management as well.”

Metformin works by decreasing the amount of glucose produced by the liver and by making muscle tissue more sensitive to insulin, the American Diabetes Association says.

SGLT-2 inhibitors increase the amount of glucose that is excreted in urine, lowering blood sugar levels, the ADA says.

The new study appears in the American Journal of Preventive Medicine.

More information

Harvard Medical School has more on the link between diabetes and dementia.

SOURCE: Elsevier, news release, July 11, 2024