Diabetes drugs GLP-1RA and SGLT2i lower dementia risk in older adults, study finds

A new study connects two widely prescribed diabetes medicines to a 33-43% lower risk of Alzheimer’s and related dementia, and offers hope for redeveloping existing treatments to tackle one of the most devastating diseases of Aging.

Study: GLP-1ra and SGLT2I drugs for type 2 diabetes and Alzheimer’s disease and related dementia. Image Credit: Peopleimages.com – Yuri A / Shutterstock.com

A recent study published in the magazine Jama Neurology Determines the potential impact of new anti-diabetes drugs on the risk of developing Alzheimer’s dementia and related dementia (ADRD).

New approaches for the treatment of ADRD

ADRD, which is characterized by progressive cognitive disorders, currently affects around seven million older adults in the United States, where researchers project that up to 14 million people will be diagnosed with ADRD in the US in the US. Recently the US Food and Drug Administration (FDA) has various disease -modifying treatments for Adacanumab, Lecanemab, Lecanemab, and Donanemab; However, their effectiveness and risks remain unclear.

In order to overcome the high costs and potential adverse effects in connection with new AD medicines, researchers have become increasingly interested in the re -use of existing medicines for new therapeutic indications. For example, various studies have recently reported that glucose-lowering medicines such as glucagon-like peptide-1 receptor agonists (GLP 1RAs) and sodium glucose Cotransporter-2 inhibitors (SGLT2Is) can reduce the risk of ADRD. Despite these observations, the relationship between these medicines and the ADRD risk remains unclear.

Study findings

Data from the electronic health file of Oneflorida+ Clinical Research Consortium were obtained between January 2014 and June 2023. All patients were at least 50 years old, diagnosed with T2DM, without an earlier diagnosis of ADRD.

Patients prescribed GLP-1RAs or SGLT2Is were more often female, younger than the total average age of the T2DM cohort and have a higher body mass index (BMI) values ​​compared to patients who prescribed other glucose-lowering medicines.

The incidence of ADRD was lower in patients who received GLP-1Ras compared to other anti-diabetes medicines, with an incidence of 4.35 and 6.6 for every 1000 person respectively. Patients prescribed SGLT2Is also had a lower risk of ADRD, at a speed of 4.19 cases for every 1000 person years compared to 7.23 cases in patients who prescribed other glucose -lowering medicines.

These findings show that both GLP-1ra and SGLT2 use were associated with a considerably reduced risk of developing ADRD. No significant difference in ADRD risk was observed when comparing GLP-1ra and SGLT2 use.

GLP-1Ras are associated with numerous health benefits that can contribute to the reduced risk of ADRD in diabetics, some of which have reduced neuro inflammation, improved insulin sensitivity in the brain and greater neurogenesis. These medicines can also promote synaptic plasticity and at the same time reduce the accumulation of amyloid-β and tau proteins.

SGLT2is can also increase blood flow to the brain and reduce exposure to oxidizing molecules, while the mitochondrial function is promoted.

Both drug classes are associated with improved vascular health and favorable metabolic effects, which are strongly linked to cognitive performance. The mechanisms of action that are shared between both GLP-1Ras and SGLT2Is that probably contribute to their comparable risk reduction profile for ADRD.

GLP-1RA use was associated with a 33% lower risk of ADRD, while the SGLT2i use was associated with a 43% lower risk compared to other glucose-lowering medicines. “

Future prospects

The development of ADRD is a long -term process that usually occurs for several years, with pathological changes that often occur before clinical symptoms can be detected. Due to the short follow-up period for the current analysis, additional studies are therefore needed to confirm the long-term neuroprotective effects of both GLP-1Ras and SGLT2is.

Longitudinal studies, in particular randomized controlled studies (RCTs), are needed to follow the long-term effects of GLP-1RA and SGLT2I use on ADRD risk in diabetics. Additional studies that apply more rigorous analytical methods, while adjustment for COVARATE FACTORS is also indicated.

Nevertheless, the research results suggest that GLP-1ras and SGLT2Is have neuroprotective effects that can be used as part of broader therapeutic regimes to prevent ADRD among diabetics. In particular, the reduced ADRD risk remained consistent when different ethnic groups, sex, obesity status and the use of insulin or metformin in the analysis were considered, indicating the generalization of these observations.