A recent study from researchers in South Korea contends that certain diabetes medications known as sodium-glucose cotransporter-2 (SGLT2) inhibitors may be linked to a reduced risk of developing dementia and Parkinson’s disease. The findings, published this week in the journal Neurology, are significant given the rising prevalence of these neurodegenerative diseases, especially among individuals with type 2 diabetes.
SGLT2 inhibitors, commonly referred to as gliflozins, work by helping the kidneys excrete excess glucose through urine, which, in turn, lowers blood sugar levels. This class of drug has gained popularity both for its glucose-lowering effects to treat type 2 diabetes and its potential cardiovascular benefits.
“We know that these neurodegenerative diseases are common and the number of cases is growing as the population ages, and people with diabetes are at increased risk of cognitive impairment,” said study author Minyoung Lee, MD, PhD, from Yonsei University College of Medicine in Seoul, South Korea. “So it’s encouraging to see that this class of drugs may provide some protection against dementia and Parkinson’s disease.”
The retrospective study included more than 358,000 people with type 2 diabetes who began treatment between 2014 and 2019 in South Korea. Participants using SGLT2 inhibitors were compared to those on other oral diabetes medications, and both groups had people with similar ages, other health conditions, and complications from diabetes. The investigators tracked the participants’ health outcomes, particularly the development of dementia or Parkinson’s disease, for an average of two years for the SGLT2 group and four years for the other medications group.
Results showed that the incidence of Alzheimer’s disease among those taking SGLT2 inhibitors was 39.7 cases per 10,000 person-years, compared to 63.7 cases for those on other medications. For vascular dementia, the incidence was 10.6 cases for SGLT2 users versus 18.7 cases and for Parkinson’s disease, the the incidence was 9.3 cases per 10,000 person-years for those using SGLT2 inhibitors, compared to 13.7 for their counterparts.
In total, after adjusting the data for various confounding factors, the team found that the use of SGLT2 inhibitors was associated with a 20% lower risk of Alzheimer’s disease and Parkinson’s disease, and a 30% reduction in the risk of vascular dementia.
“The results are generally consistent even after adjusting for factors like blood pressure, glucose, cholesterol, and kidney function,” Lee noted. However, he noted that a limitation of this study was a relatively short follow-up period, which opens that possibility that some of the people studied could develop these neurodegenerative diseases later.
The study is important as it is becoming more apparent that type 2 diabetes can be a contributing factor to the development of neurodegenerative disorders due to how its pathology, which includes inflammation, vascular problems, and the accumulation of sugar affects brain health. This intersection of diabetes and forms of dementia is a growing public health concern as the population ages. This current research, however, could provide a viable treatment option that both addresses a patient’s diabetes while potentially mitigating the risk of cognitive decline.
