A groundbreaking study from Korea suggests that sodium-glucose cotransporter-2 (SGLT-2) inhibitors, commonly used to manage type 2 diabetes, might also reduce the risk of developing dementia by 35%. This new research highlights the potential dual benefits of these medications and calls for further investigation to validate their neuroprotective effects as global dementia cases are expected to rise significantly.
Promising Findings on SGLT-2 Inhibitors
Published today in The BMJ, the study reveals that SGLT-2 inhibitors could be more effective than dipeptidyl peptidase-4 (DPP-4) inhibitors in lowering the risk of dementia. The research points to potential advantages from prolonged use of SGLT-2 inhibitors, though it was observational and thus, the researchers urge for randomized controlled trials to confirm these preliminary findings.
According to the World Health Organization, the number of people living with dementia worldwide could reach 78 million by 2030, with type 2 diabetes being a known risk factor for the disease.
Study Methodology and Results
The study analyzed data from over 110,000 adults aged 40-69 with type 2 diabetes who began treatment with either SGLT-2 inhibitors or DPP-4 inhibitors between 2013 and 2021. Researchers used the Korea National Health Insurance Service database to match participants by age, sex, diabetes drug use, and cardiovascular risk, and followed them for an average of 670 days.
Throughout the follow-up period, 1,172 participants were newly diagnosed with dementia. The dementia incidence rate was 0.22 per 100 person-years among SGLT-2 inhibitor users, compared to 0.35 per 100 person-years among those using DPP-4 inhibitors, indicating a 35% lower risk associated with SGLT-2 inhibitors. Additionally, SGLT-2 inhibitors were linked to a 39% reduced risk of Alzheimer’s disease and a 52% reduced risk of vascular dementia.
The study also found that the protective effect of SGLT-2 inhibitors increased with longer treatment duration, showing a 48% risk reduction for those treated for more than two years versus 43% for those treated for two years or less.
Implications and Future Directions
While the study’s observational nature limits the ability to draw definitive conclusions about causality, it represents significant new evidence suggesting that SGLT-2 inhibitors could offer substantial neuroprotective benefits. Researchers from Taiwan, who wrote a linked editorial, emphasize the need for additional trials to confirm these results and explore the underlying mechanisms by which SGLT-2 inhibitors may protect against dementia.
Given the current lack of effective dementia treatments and the considerable public health burden associated with both dementia and type 2 diabetes, these findings are particularly important. The authors advocate for updates to clinical guidelines and healthcare policies to reflect the potential benefits of SGLT-2 inhibitors in reducing dementia risk.
The study provides an encouraging outlook for future research and clinical practice, underscoring the need to integrate new evidence into strategies for managing and preventing dementia.
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