A study from South Korea has shown that the use of certain type 2 diabetes medications, known as SGLT2 inhibitors, is associated with a lower risk of developing neurodegenerative conditions such as Parkinson’s disease and Alzheimer’s disease. The premise behind the research was based on the common pathophysiological links between type 2 diabetes and neurodegenerative diseases, with individuals with type 2 diabetes considered to be at a higher risk for developing these conditions. Researchers hypothesized that the unique pharmacological action of SGLT2 inhibitors, which include lowering blood sugar levels and increasing urinary glucose excretion, may have neuroprotective effects.
The mechanism behind the neuroprotective effects of SGLT2 inhibitors is likely multifaceted and involves cardiovascular, metabolic, and cellular effects that target risk factors associated with dementia and Parkinson’s disease, such as hyperglycemia, insulin resistance, obesity, hypertension, and heart failure. By improving cardiovascular health, SGLT2 inhibitors may help prevent cerebrovascular damage and neurodegeneration. The study involved analyzing data from a cohort of over 350,000 participants with type 2 diabetes, comparing those taking SGLT2 inhibitors to those taking other oral antidiabetes medications over a period of several years.
The analysis found that participants taking SGLT2 inhibitors had a 21% lower risk of developing all-cause dementia, a 20% decrease in Parkinson’s disease incidence, a 19% decrease in Alzheimer’s disease incidence, and a 31% lower risk of vascular dementia. Interestingly, the study also revealed that younger populations (<65 or <70 years old) benefited more from taking SGLT2 inhibitors compared to older participants, highlighting the importance of early intervention in high-risk individuals with type 2 diabetes. Although the results suggest potential benefits for patients with type 2 diabetes taking SGLT2 inhibitors, the study is observational and further research is needed to determine the long-term effects of reduced risk. The study authors believe that the impact of SGLT2 inhibitors on neurodegenerative diseases may be more about attenuating the degenerative process and delaying the onset of dementia rather than completely preventing it. Additional research is needed to elucidate the underlying mechanism behind the observed reduction in risk, with ongoing studies using animal models of dementia associated with metabolic disorders to explore how SGLT2 inhibitors positively affect neurodegenerative diseases. While population-level implications of reducing the risk of dementia are significant, the perspective of prevention may differ for individual patients, as it may imply an expectation of never developing dementia in their lifetime.
