A recent study published in The BMJ has revealed a potential link between Sodium-glucose cotransporter-2 (SGLT-2) inhibitors, a class of drugs used to treat type 2 diabetes, and a reduced risk of developing dementia. The observational study, analyzing data from over 200,000 individuals, suggests that SGLT-2 inhibitors may offer a protective effect against dementia, warranting further investigation through controlled clinical trials.
Study Details and Findings
The study followed adults aged 40-69 years with type 2 diabetes, comparing the incidence of dementia in those initiating treatment with SGLT-2 inhibitors versus dipeptidyl peptidase-4 (DPP-4) inhibitors. The results indicated a statistically significant association between SGLT-2 inhibitor use and a lower risk of dementia. While the exact risk reduction percentage requires careful interpretation due to the observational nature of the study, experts suggest the effect could be substantial.
Expert Perspectives
Professor Tara Spires-Jones from the University of Edinburgh noted that the study adds to the growing body of evidence linking diabetes to dementia risk and suggests that treating conditions like diabetes can lower the risk of developing dementia. Dr. Ivan Koychev from the University of Oxford highlighted that the findings align with existing epidemiological evidence for dementia risk reduction through diabetes medications, particularly SGLT2-inhibitors and glucagon-like peptide-1 receptor agonists, with risk reductions of 30-40% observed in some studies. He also noted that the mechanisms through which these effects take place are unknown but likely relate to either affecting inflammation in the brain, reducing the risk for cerebrovascular events or modulating glucose metabolism in the brain.
Implications and Future Research
The findings have significant implications for dementia research and treatment strategies. Dr. Jacqui Hanley from Alzheimer’s Research UK emphasized the urgent need for effective dementia treatments and highlighted the potential of repurposing existing drugs, like SGLT-2 inhibitors, to address this need. Since these drugs have already been shown to be safe for use in people, this could potentially speed up the process of testing them in clinical trials against dementia, as well as making it significantly cheaper.
Cautions and Considerations
Despite the promising results, experts caution against drawing definitive causal links from this observational study. Professor William Whiteley from the University of Edinburgh pointed out the limitations of using health record data to determine the effects of a medicine and emphasized the need for ongoing randomized trials to provide more reliable answers. He suggested that the observed effect size might be overestimated due to the study design.
Ongoing Research
Several randomized trials are currently underway to investigate the potential of diabetes medicines in preventing or slowing dementia progression. The results of these trials are expected to provide more definitive evidence regarding the efficacy of SGLT-2 inhibitors and other diabetes drugs in mitigating dementia risk.
