People with type 2 diabetes have an increased risk of developing dementia due to shared cardiovascular problems. High blood sugar levels over time can damage blood vessels in the brain, leading to a decrease in blood and oxygen reaching brain cells. This damage can cause cognitive decline and increase the risk of vascular dementia. Insulin resistance, a hallmark of type 2 diabetes, is also linked to a higher chance of developing Alzheimer’s disease, further increasing the risk of dementia. Other factors associated with type 2 diabetes, such as high blood pressure and cholesterol levels, can also contribute to an increased risk of developing dementia.
SGLT-2 inhibitors are relatively new drugs used to treat type 2 diabetes by preventing the kidneys from reabsorbing as much glucose. This allows the body to remove excess glucose through urine rather than re-entering the bloodstream. Several FDA-approved SGLT-2 inhibitors are available on the market and are commonly prescribed to individuals with type 2 diabetes. Research suggests that these drugs may offer additional benefits beyond treating diabetes, including reducing the risk of dementia. Previous studies have shown that SGLT-2 inhibitors might protect against cognitive decline, but more research is needed to confirm these findings.
A recent large-scale study published in The BMJ investigated the links between SGLT-2 inhibitors and dementia risk in individuals with type 2 diabetes. The study compared people taking SGLT-2 inhibitors with those taking another class of anti-diabetes drugs, called DPP-4 inhibitors. Participants who took SGLT-2 inhibitors had a 35% reduced risk of developing dementia compared to those on DPP-4 inhibitors. The protective effect of SGLT-2 inhibitors was more pronounced in participants who had been using the drug for longer periods.
The study also found that SGLT-2 inhibitors were associated with a lower risk of developing specific types of dementia, including vascular dementia and Alzheimer’s disease. Participants who took SGLT-2 inhibitors for more than two years had a greater risk reduction compared to those who took the drug for less than two years. Although the study was observational and the effect size might be overestimated, the results are relatively robust and show promising potential for using SGLT-2 inhibitors to prevent dementia in individuals with type 2 diabetes.
To reduce the risk of dementia in people with type 2 diabetes, healthcare providers recommend maintaining normal blood pressure and blood sugar levels, maintaining a healthy body weight, engaging in regular physical activity, avoiding tobacco use, and managing stress. Dietary interventions such as reducing alcohol intake and consuming fiber-rich foods like whole grains, vegetables, and fruits may also help reduce the risk of developing dementia. Monitoring glucose levels, using medications as prescribed, and making healthy lifestyle changes can help individuals with type 2 diabetes reduce their risk of developing dementia and other complications associated with the disease.
Overall, the study’s findings suggest that SGLT-2 inhibitors may play a role in preventing dementia in individuals with type 2 diabetes. While the dementia epidemic is a growing concern due to the aging population and increasing prevalence of type 2 diabetes, managing the disease with medication and making healthy lifestyle choices can help reduce the risk of developing dementia. Further research, including randomized controlled trials, is needed to confirm the results of the study and determine the efficacy of SGLT-2 inhibitors in preventing dementia in people with type 2 diabetes.
