Some diabetes medications can reduce the risk

• The number of neurodegenerative diseases is increasing worldwide, which is why intensive research is being carried out into the prevention of these problems.
• Some research suggests that certain drugs for type 2 diabetes – called SGLT2 inhibitors – may reduce the incidence of some neurodegenerative diseases such as Parkinson's and Alzheimer's.
• A large cohort study has now shown that taking these medications is associated with a lower risk of developing these neurodegenerative diseases.

As a study from South Korea shows, the risk of Parkinson's and Alzheimer's disease decreases in people who take a drug for type 2 diabetes.

Minyoung Lee, MD, PhD, of Yonsei University College of Medicine in Seoul, South Korea, and co-author of the article told Medical news today the premise of the study by her and her colleagues.

“There are shared pathophysiological links between type 2 diabetes and neurodegenerative diseases, and individuals with type 2 diabetes are considered to be at particular risk for developing neurodegenerative diseases,” she told us. “Consequently, there has been research into whether diabetes drugs might be helpful in neurodegenerative diseases, but to date no drug has provided clear evidence to support this.”

“When I started my research, SGLT2 inhibitors had been introduced as a new treatment for diabetes. These drugs not only lower blood sugar but also increase urinary glucose excretion, leading to lower insulin levels and increased ketone bodies in the body. Since ketones are known to be beneficial metabolites for the nervous system, I hypothesized that the unique pharmacological action of SGLT2 inhibitors might make them particularly useful for reducing the risk of neurodegenerative diseases,” explained Lee.

Steve Allder, MD, a consulting neurologist at Re:Cognition Health who was not involved in this research, suggested MNT “The mechanism behind the neuroprotective effects of SGLT2 inhibitors is likely complex and includes cardiovascular, metabolic and cellular effects.”

“SGLT2 inhibitors reduce common risk factors associated with dementia and Parkinson's disease, such as hyperglycemia, insulin resistance, obesity, hypertension, and heart failure. These factors contribute to both vascular dementia and Alzheimer's disease. By improving cardiovascular health, SGLT2 inhibitors may likely help prevent cerebrovascular damage and neurodegeneration.”

To investigate whether the use of SGLT2 inhibitors affects the risk of neurodegenerative diseases, the researchers analyzed data from a cohort of 358,862 participants with type 2 diabetes.

Participants who started taking SGLT2 inhibitors between 2014 and 2019 were compared with participants taking other oral antidiabetic drugs. All participants were over 40 years of age.

The analysis found that over an average observation period of 2.06 years in people taking SGLT2 inhibitors and 3.70 years in people taking various antidiabetic drugs, the risk of developing dementia from any cause was reduced by 21% in the group taking SGLT2 inhibitors.

In addition, a 20% reduction in Parkinson's disease and a 19% reduction in Alzheimer's disease were observed in this group. The risk of vascular dementia was 31% lower.

Daniel Truong, MD, neurologist, medical director of the Truong Neuroscience Institute at MemorialCare Orange Coast Medical Center in Fountain Valley, CA, and editor-in-chief of Journal of Clinical Parkinsonism and Related Disorderswho was not involved in the investigation, said MNT The:

“Another surprising result is the greater benefit in younger population groups (

The study authors say the results show there are potential benefits for patients with type 2 diabetes taking SGLT2 inhibitors, which is important because they are at increased risk of neurological disease. However, they note that the study is observational and further studies are needed to determine how long-term this reduced risk is.

Lee told us, “I think the effect of SGLT2 inhibitors on neurodegenerative diseases is more in line with the concept of attenuating the degenerative process and delaying the onset of dementia than the concept of preventing dementia so that it doesn't occur in the first place.”

“At the population level, reducing the population at risk of dementia and changing social conditions could be called 'prevention'. However, the meaning of prevention from the perspective of an individual may differ from that of the population, as it may imply the expectation that no case of dementia will occur in their lifetime,” she warned.

Further work is needed to elucidate the mechanism behind the observed risk reduction, Lee said. “I am researching a mouse model of dementia associated with metabolic disorders to study how SGLT2 inhibitors have a beneficial effect on neurodegenerative diseases,” she noted.

“Previous studies have evaluated the drug's potential from a broader perspective using a nationwide database. However, my current work is dedicated to mechanistic studies aimed at elucidating these effects,” Lee said. MNT.