Dementia is a major health concern worldwide due to the aging population and its devastating impact on quality of life. As cases of Alzheimer’s and vascular dementia increase, scientists are looking for new ways to prevent or delay cognitive decline. One promising area is the link between type 2 diabetes and dementia, as people with diabetes are at higher risk of developing these neurodegenerative diseases.
Recently, a study carried out in Korea has revealed that certain diabetes drugs, such as SGLT-2 inhibitors, not only help control blood sugar levels, but could also reduce the risk of developing dementia. These medications, in addition to their effects on glucose, improve vascular health, promote weight loss and reduce inflammation, all protective factors for the brain and its health.
In this article, We will explore how these diabetes drugs could become a key tool for dementia prevention and what implications this finding has for the future treatment of neurodegenerative diseases.
To understand the action of diabetes drugs in the treatment and prevention of dementia, it is important to first clearly establish what both conditions are based on.
Type 2 diabetes is a condition in which the body does not produce enough insulin or use it effectively, often resulting in high blood sugar levels. This excess glucose can damage blood vessels and nerves throughout the body, even reaching the brain. This vascular impairment, combined with the chronic inflammation that often accompanies diabetes, increases the risk of developing a variety of health problems, including dementia.
Dementia is a group of neurodegenerative disorders that primarily affect memory, thinking, behavior, and the ability to carry out everyday tasks. The most common forms of dementia are Alzheimer’s and vascular dementia. Alzheimer’s is linked to the buildup of beta-amyloid protein plaques in the brain, while vascular dementia results from damage to blood vessels, which affects blood supply to the brain.
The connection between diabetes and dementia has been the subject of research for years. It has been observed that people with diabetes are up to 50% more likely to develop Alzheimer’s or vascular dementia at some point in their lives compared to those who do not suffer from this disease. This is due in part to the damaging effects of hyperglycemia on the brain’s blood vessels, which limits the flow of oxygen and nutrients essential for cognitive functioning.
Besides, Chronic inflammation resulting from high blood sugar levels can also accelerate the deterioration of brain cells increasing the risk of cognitive decline and possible development of dementia. Although the exact mechanism is not fully understood, diabetes control could be a key piece in reducing the risk of developing dementia in the long term.
The Korean Study: Key Findings
A recent study conducted in Korea explored how different type 2 diabetes drugs may interfere with the chance of developing dementia. The study included more than 110,100 people with type 2 diabetes, ages 40 to 69, who were prescribed two types of medications: SGLT-2 inhibitors and DPP-4 inhibitors. Over a 670-day follow-up period, researchers compared the health outcomes of both groups, especially in relation to the onset of dementia.
The results of the study were surprising: patients who took SGLT-2 inhibitors were 35% less likely to develop dementia compared to those who used DPP-4 inhibitors. This finding is especially significant, as both groups achieved similar control of blood glucose levels, suggesting that the benefit of SGLT-2 inhibitors goes beyond glycemic control.
The study highlights that, although DPP-4 inhibitors have also been shown to be effective for blood sugar control, they did not offer the same protection against cognitive decline as SGLT-2 inhibitors. This raises the question of why one drug appears to reduce the risk of dementia more than another, even though both control diabetes effectively.
The researchers suggest that the difference between the effect of both drugs could be related to the additional effects that SGLT-2 inhibitors have on vascular and metabolic health. These medications not only remove excess glucose through the kidneys, but also improve blood pressure, promote weight loss, and reduce inflammation and oxidative stress. These overall health improvements could be contributing to greater protection against brain damage that leads to dementia, making SGLT-2 inhibitors a promising option for the prevention of cognitive decline.
How SGLT-2 drugs work in the brain
SGLT-2 inhibitors are a class of pharmacological medications originally designed for the treatment of type 2 diabetes. They work by blocking glucose reabsorption in the kidneys, allowing excess blood sugar to be removed through the urine. This mechanism helps control blood glucose levels, but as we have mentioned, recent research suggests that its benefits go beyond glucose and diabetes, also extending to the brain and the prevention of dementia.
1. Blood pressure and body weight
One of the key aspects of SGLT-2 inhibitors is that, in addition to lowering blood sugar, they also have positive effects on blood pressure and body weight. Reducing blood pressure is crucial because hypertension is a major risk factor for vascular dementia a type of dementia caused by damage to blood vessels in the brain. By improving vascular health, SGLT-2 inhibitors may help prevent cognitive decline related to poor cerebral blood circulation.
2. Anti-inflammatory and antioxidant effects
In addition, these medications have anti-inflammatory and antioxidant effects that could be essential in protecting the brain. Chronic inflammation is a known contributor to brain cell deterioration, and oxidative stress, which damages cells at a molecular level, is a factor implicated in the development of Alzheimer’s and other forms of dementia. By reducing inflammation and oxidative stress, SGLT-2 inhibitors could slow or prevent the buildup of damage in the brain leading to loss of memory and cognitive function.
Future Perspectives: Dementia Prevention
The promising results of SGLT-2 inhibitors in reducing the risk of dementia open a new door in the prevention of neurodegenerative diseases, not only for people with diabetes, but potentially for the general population. Although these drugs were originally designed for the treatment of type 2 diabetes, their ability to improve vascular health, reduce inflammation and reduce oxidative stress has generated interest in their possible preventive use in people who do not have diabetes, but do have risk factors. risk for the development of dementia.
A future direction in dementia treatment could include using these drugs in combination with other therapeutic approaches, similar to how drug combinations are used to treat cancer. Dementia is a complex disease with multiple factors involved, so it is unlikely that a single intervention will be sufficient to prevent or treat the disease entirely. However, SGLT-2 inhibitors could be part of a broader strategy to reduce this risk.
Despite the advances, it is important to highlight the need for more clinical studies to confirm the long-term effects of these medications in preventing dementia in people who do not have diabetes. While current findings are promising, use of drugs outside their original indication requires careful assessment of risks and benefits. With more research, these drugs could become an important tool in combating the global rise in dementia.
Conclusions
The discovery of SGLT-2 inhibitors, used in the treatment of type 2 diabetes, and their influence on reducing the risk of dementia opens new possibilities in the prevention of neurodegenerative diseases. By improving vascular health, reducing inflammation and combating oxidative stress, these drugs can protect the brain, not only in patients with diabetes, but also in people at risk of dementia. Although the current results are promising, more research is required to confirm its effectiveness in widespread dementia prevention. These advances offer hope to combat the growing impact of this disease worldwide.
