Diabetes: Sugar lowering drug protects against dementia
All content is checked by medical journalists.Diabetics are more likely to develop dementia than people with a healthy sugar metabolism. But that does not apply to patients who take the blood sugar lowering drug pioglitazone. In fact, they are more likely to remain mentally fit than healthy people.
Bonn researchers from the German Center for Neurodegenerative Diseases (DZNE) discovered this connection when they evaluated the health insurance data of more than 145,000 men and women over 60.
"Remarkable side effect"
“Treatment with pioglitazone showed a remarkable positive side effect. It was able to significantly reduce the risk of dementia, "says the demographer Gabriele Doblhammer, one of the scientists involved." The longer the treatment, the lower the risk. "It fell most noticeably when the active ingredient was administered for at least two years treated patients, the risk of developing the disease was 47 percent lower than for non-diabetics - it was only half as high. Those who took the also frequently prescribed diabetes drug metformin were less likely to develop dementia. The protective effect was, however, significantly less than that of pioglitazone.
A big downer, however, is that pioglitazone, on the other hand, increases the risk of bladder cancer. For this reason, it has rarely been prescribed and no longer paid for by the statutory health insurance funds in recent years.
Sugar gnaws at the vessels
In patients with type 2 diabetes, the body cells react increasingly poorly to insulin. Pioglitazone improves the effect of the body's own hormone again. It is particularly suitable for patients in whom the overtaxed pancreas has not yet largely stopped producing insulin.
Laboratory studies have long suggested that pioglitazone also protects nerve cells. "Pioglitazone is anti-inflammatory and reduces the deposition of damaging proteins in the brain," explains neuroscientist Michael Heneka, who was also involved in the study. Apparently, the drug works preventively against dementia, long before the first symptoms appear.
It remains to be seen whether such an effect would also occur in non-diabetics. Further investigations would be necessary for this.
Double the risk of Alzheimer's
People with type 2 diabetes are 1.5 to 2 times more likely to have Alzheimer's than people with a healthy sugar metabolism. And they are up to four times more likely to develop the second most common form of dementia, vascular dementia, in which the brain is not supplied with sufficient blood.
One explanation for this phenomenon is the permanently high sugar levels in the blood. They damage blood vessels - including those in the brain. Regardless of this, the frequent comorbidities of type 2 diabetes such as high blood pressure, obesity, lipid metabolism disorders and depression also increase the risk of dementia.
The combination of dementia and diabetes is tricky. Because if you are no longer mentally up to date, you are no longer able to coordinate medication and nutrition. Then there is a threat of severe, sometimes life-threatening hypoglycaemia. (cf)
Source: Michael T. Heneka et al .: Effect of pioglitazone medication on the incidence of dementia
Annals of Neurology 2015, doi: 10.1002 / ana.24439
