Lower Parkinson's disease, dementia risk with use of SGLT2...

23 Sep 2024, 12:00 by Andrea Lobo · Parkinson's News Today

SGLT2 inhibitors, which are a type of medication to treat diabetes, may reduce the risk for neurodegenerative conditions, including Parkinson’s disease and dementia, a study from South Korea suggests.

The overall risk for developing dementia due to any cause and Parkinson’s was lower in patients taking SGLT2 inhibitors than in those treated with other anti-diabetic medications.

“We know that these neurodegenerative diseases … are common and the number of cases is growing as the population ages, and people with diabetes are at increased risk of cognitive impairment,” Minyoung Lee, MD, PhD, researcher at Yonsei University College of Medicine in Seoul, and lead author of the study, said in a press release. “[I]t’s encouraging to see that this class of drugs may provide some protection against dementia and Parkinson’s disease.”

The study, “SGLT2 Inhibitor Use and Risk of Dementia and Parkinson Disease Among Patients With Type 2 Diabetes,” was published in Neurology.

Sodium-glucose cotransporter-2 (SGLT2) inhibitors, also called gliflozins, reduce blood sugar by causing the kidneys to remove sugar from the body through urine. The treatments are known to improve neurologic outcomes, but their “efficacy … in neurodegenerative disorders among patients with type 2 diabetes is not well established.” Type 2 diabetes is a chronic health condition wherein the body becomes resistant to the effects of insulin or doesn’t produce enough insulin, resulting in high blood sugar.

SGLT2 inhibitor use and Parkinson’s, dementia cases

Researchers retrospectively analyzed 358,862 patients with type 2 diabetes who were included in the Korean National Health Insurance Service Database and treated with SGLT2 inhibitors or other diabetes medications. The patients had a mean age of 57.8, were primarily male (58%), and were followed up for two to four years.

A total of 6,837 people developed dementia or Parkinson’s during the study. The incidence rate of Parkinson’s was lower in patients taking SGLT2 inhibitors than those taking other diabetes medications, 9.3 vs. 13.7 cases per 10,000 person-years, which accounts for both the number of participants in a study and the duration of their participation.

A similar effect was observed in patients who developed dementia; a lower incidence rate of Alzheimer’s disease, the most common cause of dementia (39.7 vs. 63.7 cases per 10,000 person-years), and dementia caused by vascular disease (10.6 vs. 18.7 cases per 10,000 person-years) among those taking SGLT2 inhibitors.

After adjusting for other factors that could affect the risk of dementia or Parkinson’s disease, including diabetes complications or effects medications, researchers found SGLT2 inhibitor use was associated with a 20% reduced risk of developing Parkinson’s disease, a 19% reduced risk for Alzheimer’s disease, and a 31% lower risk for vascular dementia. SGLT2 inhibitor use also was linked to a 21% reduced risk of all-cause dementia and a 22% reduced risk of both dementia and Parkinson’s disease compared with other anti-diabetic medications. This association wasn’t affected by sex, coexistent conditions, diabetes complications, or medications.

According to Lee, “the results are generally consistent even after adjusting for factors like blood pressure, glucose, cholesterol, and kidney function.” However, since the participants were followed for less than five years, it’s possible that some patients could develop Parkinson’s or dementia later in life, meaning “more research is needed to validate the long-term validity of these findings.”