Diabetes Drug Could Ward Off Dementia

Current analysis suggests a possible hyperlink between the diabetes drug pioglitazone and a diminished threat of dementia in folks with newly identified sort 2 diabetes. The examine, led by Dr. Eosu Kim from Yonsei College, analyzed information from 91,218 individuals over a median of 10 years, displaying that these taking pioglitazone had been 16% much less prone to develop dementia. This share rose to 37% in these taking the drug for 4 years. The impact was extra pronounced in folks with a historical past of ischemic coronary heart illness or stroke.

A examine within the Neurology journal means that the diabetes drug pioglitazone might cut back dementia threat in newly identified sort 2 diabetics, with advantages amplified in these with a historical past of ischemic coronary heart illness or stroke. Nevertheless, the drug’s potential unintended effects name for additional analysis into its long-term security and effectiveness.

Folks with diabetes are twice as prone to develop dementia as these with out the illness. In a brand new examine, folks with newly identified sort 2 diabetes who took the diabetes drug pioglitazone had been much less prone to later develop dementia than those that didn’t take the drug. The examine was printed within the February 15, 2023, on-line difficulty of Neurologythe medical journal of the American Academy of Neurology.

The outcomes had been strongest amongst individuals who additionally had a historical past of stroke or ischemic coronary heart illness, a situation brought on by narrowed arteries within the coronary heart. The examine doesn’t show that the drug reduces the chance of dementia for folks with diabetes. It solely exhibits an affiliation.

“Since dementia develops for years earlier than analysis, there could also be a chance for intervening earlier than it progresses,” stated examine creator Eosu Kim, MD, PhD, of Yonsei College in Seoul, Republic of Korea. “These outcomes might recommend that we may use a customized strategy to stopping dementia in folks with diabetes within the case that they’ve a historical past of ischemic coronary heart illness or stroke.”

For the examine, researchers appeared on the nationwide Korean well being database for folks newly identified with sort 2 diabetes who didn’t have dementia. They had been adopted for a median of 10 years. Of the 91,218 individuals, 3,467 acquired the drug pioglitazone.

Through the examine, 8.3% of the folks taking pioglitazone developed dementia, in comparison with 10.0% of those that weren’t taking the drug. After researchers accounted for different components that might have an effect on dementia threat, reminiscent of hypertension, smoking and bodily exercise, they discovered that individuals taking pioglitazone had been 16% much less prone to develop the illness than those that didn’t take it. The profit was stronger amongst individuals who had a historical past of ischemic coronary heart illness or stroke, with diminished dangers of 54% and 43%.

The diminished threat additionally elevated as folks used the drug for longer intervals. Individuals who took the drug for 4 years had been 37% much less prone to develop dementia than those that didn’t take the drug, whereas those that took it for one to 2 years had been 22% much less doubtless.

Folks taking the drug had been additionally much less prone to have a stroke through the examine.

Kim famous that unintended effects of pioglitazone embody swelling, weight acquire, bone loss, and congestive coronary heart failure, and extra analysis is required on the long-term security of the drug and whether or not there may be an optimum dose that might decrease unintended effects whereas sustaining the advantages.

“These outcomes present helpful data on who may probably profit from pioglitazone use for prevention of dementia,” Kim stated. “In some earlier research of individuals with dementia or prone to cognitive decline who didn’t have diabetes, pioglitazone didn’t present any safety in opposition to dementia, so it’s doubtless {that a} essential issue affecting the effectiveness is the presence of diabetes. Extra analysis is required to verify these findings.”

A limitation of the examine was data on medicine was based mostly on insurance coverage claims, so it’s attainable that some folks didn’t take the medicine as prescribed.

Reference: “Pioglitazone Use and Decreased Danger of Dementia in Sufferers With Diabetes Mellitus With a Historical past of Ischemic Stroke” by Junghee Ha, Dong Woo Choi, Kim, Keun You Kim, Chung Mo Nam and Eosu Kim, 15 February 2023, Neurology.
DOI: 10.1212/WNL.0000000000207069

The examine was supported by the Korean Ministry of Well being and Welfare and the Nationwide Analysis Basis of Korea.