The Promising Potency of Sodium–Glucose Cotransporter 2 Inhibitors in the Prevention of and as Treatment for Cognitive Impairment Among Type 2 Diabetes Patients DOI Creative Commons

Yibin Zhang,

Xiao-xing Liao,

Jialu Xu

et al.

Biomedicines, Journal Year: 2024, Volume and Issue: 12(12), P. 2783 - 2783

Published: Dec. 6, 2024

Type 2 diabetes mellitus (T2DM), accounting for the majority of prevalence, is associated with an increased risk cognition decline and deterioration function in diabetic patients. The sodium–glucose cotransporter (SGLT2), located renal proximal tubule, plays a role urine glucose reabsorption. SGLT2 inhibitors (SGLT2i), have shown potential benefits beyond cardiac improvement preventing treating cognitive impairment (CI), including mild impairment, Alzheimer’s disease vascular dementia T2DM Studies suggest that SGLT2i may ameliorate CI through metabolism pathways, inflammation, oxidative stress, neurotrophic factors AChE inhibition. Clinical trials meta-analyses reported significant insignificant results. Given their effects, offer unique protection against CI. This review compiles mechanisms clinical evidence, emphasizing need future analysis, evaluation, to verify recommend optimal selection dosage specific

Language: Английский

Comparative Effectiveness of SGLT2 Inhibitors and GLP-1 Receptor Agonists in Preventing Alzheimer's Disease, Vascular Dementia, and Other Dementia Types Among Patients with Type 2 Diabetes DOI
Mingyang Sun, Xiaoling Wang, Zhongyuan Lu

et al.

Diabetes & Metabolism, Journal Year: 2025, Volume and Issue: unknown, P. 101623 - 101623

Published: Feb. 1, 2025

Language: Английский

Citations

2
Use of sodium‐glucose cotransporter‐2 inhibitors and risk of dementia: A population‐based cohort study DOI
Lin Zhuo,

Baixue Zhang,

Yueqi Yin

et al.

Diabetes Obesity and Metabolism, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 10, 2025

The effects of sodium-glucose co-transporter 2 inhibitors (SGLT-2i) on dementia risk have not been assessed in the Chinese population. We aimed to assess association between use SGLT-2i and incidence a mainland A target trial vs. dipeptidyl peptidase 4 (DPP-4i) was emulated, with cohorts type diabetes mellitus patients who were new users or DPP-4i being assembled using Yinzhou Regional Health Care Database. Inverse probability treatment weighting (IPTW) applied control potential confounding, Cox model used estimate hazard ratio (HR) incident dementia. final cohort included 47 335 SGLT-2i. In primary analysis, 500.2 347.5 per 100 000 person-years SGLT-2i, respectively. associated reduced after adjusting for confounding IPTW, an HR 0.74 (95% CI, 0.60-0.93). results generally consistent various subgroup analyses sensitivity analyses. is decreased study population China.

Language: Английский

Citations

1
The pharmacodynamics-based prophylactic benefits of GLP-1 receptor agonists and SGLT2 inhibitors on neurodegenerative diseases: evidence from a network meta-analysis DOI Creative Commons
Ping‐Tao Tseng,

Bing‐Yan Zeng,

Chih-Wei Hsu

et al.

BMC Medicine, Journal Year: 2025, Volume and Issue: 23(1)

Published: April 6, 2025

Abstract Background Glucagon-like peptide-1 (GLP-1) receptor agonists and sodium–glucose cotransporter 2 (SGLT2) inhibitors represent a new generation of antihyperglycemic agents that operate through mechanisms distinct from conventional diabetes treatments. Beyond their metabolic effects, these medications have demonstrated neuroprotective properties in preclinical studies. While clinical trials explored therapeutic potential established neurodegenerative conditions, role disease prevention remains unclear. We conducted network meta-analysis (NMA) to comprehensively evaluate the prophylactic benefits across multiple diseases identify most promising preventive strategies. Methods systematically searched PubMed, Embase, ClinicalKey, Cochrane CENTRAL, ProQuest, ScienceDirect, Web Science, ClinicalTrials.gov October 24th, 2024, for randomized controlled (RCTs) GLP-1 or SGLT2 inhibitors. Our primary outcome was incidence seven major diseases: Parkinson’s disease, Alzheimer’s Lewy body dementia, sclerosis, amyotrophic lateral frontotemporal Huntington’s disease. Secondary outcomes included safety profiles assessed dropout rates. performed frequentist-based NMA evaluated risk bias with Risk Bias tool. The main result current study would be re-affirmed via sensitivity test Bayesian-based NMA. Results analysis encompassed 22 RCTs involving 138,282 participants (mean age 64.8 years, 36.4% female). Among all investigated medications, only dapagliflozin significant benefits, specifically preventing (odds ratio = 0.28, 95% confidence intervals 0.09 0.93) compared controls. Neither nor other showed effects any conditions. Drop-out rates were comparable Conclusions This comprehensive reveals novel specific effect against representing breakthrough neurology. specificity dapagliflozin’s protective might rely on its highly selective inhibition SGLT2. These findings provide important direction future research could inform strategies populations at Trial registration PROSPERO CRD42021252381.

Language: Английский

Citations

1
Risk of depression and dementia among individuals treated with sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists DOI
Osvaldo P. Almeida

Current Opinion in Psychiatry, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 20, 2025

Purpose of the review To whether sodium-glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists decrease risk depression, suicidal ideation cognitive impairment in later life. Recent findings The results studies using information derived from large registries administrative health datasets suggest that GLP-1 (RAs) increase suicidality, although have been inconsistent. One nested-case control study reported SGLT2i decreases depression among adults with diabetes, a small trial empagliflozin provided supportive evidence. Several observational RAs dementia risk, target finding greater benefit associated use compared other medicines commonly used to manage diabetes. Summary RA may effects these on mood not as well explored, but there are concerns about potential increased suicidality users. Prescription bias could explain some associations, so robust evidence is now needed confirm or dismiss findings.

Language: Английский

Citations

0
Comparative risk of dementia in diabetic stroke patients prescribed SGLT2 vs. DPP-4 inhibitors: A propensity-matched retrospective cohort study DOI Creative Commons

Pei-Chun Chiang,

Cheng-Yang Hsieh,

Sheng‐Feng Sung

et al.

Journal of Stroke and Cerebrovascular Diseases, Journal Year: 2025, Volume and Issue: unknown, P. 108276 - 108276

Published: March 1, 2025

Diabetes is a significant risk factor for both stroke and dementia. This study aimed to compare the of incident dementia between sodium-glucose cotransporter 2 (SGLT2) inhibitors dipeptidyl peptidase-4 (DPP-4) in diabetic patients with history ischemic stroke. We conducted propensity-matched retrospective cohort using observational data from TriNetX global federated health research network. Patients aged 18 years or older type diabetes (T2D) stroke, newly prescribed either an SGLT2 DPP-4 inhibitor July 1, 2013, June 30, 2024, were included. Propensity score matching was employed balance baseline characteristics treatment groups. The primary outcome dementia, secondary outcomes including degenerative vascular After propensity matching, each group consisted 15901 patients. Over mean follow-up 2.52 years, use associated lower risks overall (hazard ratio [HR] 0.66; 95% confidence interval [CI] 0.59-0.74), (HR 0.68; CI 0.60-0.76), 0.59, 0.49-0.70) compared use. These findings remained consistent across various sensitivity subgroup analyses. In initiating inhibitors, association observed dementias. support preferential this high-risk population, warranting further investigation through randomized clinical trials.

Language: Английский

Citations

0
Sodium‐glucose cotransporter‐2 inhibitors and subtype‐specific dementia risk: A multinational and multiethnic cohort study DOI
Mingyang Sun, Xiaoling Wang, Zhongyuan Lu

et al.

Diabetes Obesity and Metabolism, Journal Year: 2025, Volume and Issue: unknown

Published: April 10, 2025

Abstract Aims Type 2 diabetes mellitus (T2DM) significantly increases the risk of dementia, including Alzheimer's disease (AD), vascular dementia (VaD) and mixed dementia. Although sodium‐glucose cotransporter‐2 inhibitors (SGLT2i) have shown potential neuroprotective effects, previous studies were limited by small sample sizes, single‐country datasets a lack detailed analyses subtypes. Materials Methods This retrospective cohort study utilized TriNetX database, comprising de‐identified electronic health records from over 100 million patients across 98 healthcare organizations worldwide. Adults with T2DM initiating treatment either SGLT2i or dipeptidyl peptidase‐4 (DPP4i) between November 20, 2004, 2024, included. Propensity score matching (PSM) at 1:1 ratio ensured balanced baseline characteristics. Primary outcomes included overall specific subtypes (VaD, AD, other dementias), while secondary all‐cause mortality. Results After propensity matching, 278 689 per group analysed. use was associated lower incidence (2.9% vs. 6.7%; adjusted hazard [AHR] 0.77, 95% confidence interval [CI], 0.75–0.79) (AHR 0.80), 0.82) dementias 0.68). These associations remained consistent age, sex, glycaemic control concurrent medication in subgroup analyses. also linked to mortality (4.1% 11.2%; AHR 0.66, CI, 0.65–0.68). Findings robust sensitivity analyses, supporting effects SGLT2i. Conclusions large‐scale observational suggests that is risks multiple T2DM.

Language: Английский

Citations

0
Comparative study of SGLT2 inhibitors and metformin: evaluating first-line therapies for dementia prevention in type 2 diabetes DOI
Mingyang Sun,

Xiaoling Wang,

Zhongyuan Lu

et al.

Diabetes & Metabolism, Journal Year: 2025, Volume and Issue: unknown, P. 101655 - 101655

Published: April 1, 2025

Language: Английский

Citations

0
Expanding the Use of SGLT2 Inhibitors in T2D Patients Across Clinical Settings DOI Creative Commons
Alessandro Cuttone, Vittorio Cannavò, Rana Abdullah

et al.

Cells, Journal Year: 2025, Volume and Issue: 14(9), P. 668 - 668

Published: May 2, 2025

Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are currently recommended in patients with type 2 diabetes (T2D) to reduce serum glucose levels. Moreover, robust evidence has clearly demonstrated their beneficial cardiovascular and renal effects, making this class of drugs pivotal for the treatment T2D, especially when complicated by diabetic kidney disease or heart failure. However, several other comorbidities frequently encountered T2D beyond these long-term complications, internal medicine setting. For some comorbidities, such as MAFLD cognitive impairment, association is increasingly recognized, hypothesis a common pathophysiologic background, whereas, others, coincident epidemiology linked ageing populations, including that subjects, may be advocated. In effort personalizing treatment, on potential effects SGLT2i different clinical conditions accumulating. The purpose narrative review update current literature settings glycaemic control, elucidate molecular mechanisms which they exert effects.

Language: Английский

Citations

0
Anti-Diabetic Drug Use and Reduced Risk of Parkinson's Disease: A Community-Based Cohort Study DOI
Violetta Rozani,

Miri Glikshtein Bezimianski,

Joseph Azuri

et al.

Parkinsonism & Related Disorders, Journal Year: 2024, Volume and Issue: 128, P. 107132 - 107132

Published: Sept. 6, 2024

Language: Английский

Citations

3
Translational research on cognitive impairment in chronic kidney disease DOI
Carsten A. Wagner, Ziad A. Massy, Giovambattista Capasso

et al.

Nephrology Dialysis Transplantation, Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 14, 2024

ABSTRACT Cognitive decline is common in patients with acute or chronic kidney disease. Several areas of brain function can be affected, including short- and long-term memory, attention inhibitory control, sleep, mood, eating control motor function. disease shares risk factors cognitive dysfunction people without disease, such as diabetes, high blood pressure, sedentary lifestyle unhealthy diet. However, additional kidney-specific may contribute, uremic toxins, electrolyte imbalances, inflammation, acid–base disorders endocrine dysregulation. Traditional interact to cause damage the blood–brain barrier, induce vascular neurotoxicity neuroinflammation. Here, we discuss recent insights into pathomechanisms from animal models novel avenues for prevention therapy. We focus on a several that influence cognition: barrier disruption, role skeletal muscle, physical activity factor irisin, emerging therapeutic sodium-glucose cotransporter 2 (SGLT2) inhibitors glucagon-like peptide 1 (GLP-1) receptor agonists. Taken together, these studies demonstrate importance providing mechanistic understanding this complex condition their potential explain mechanisms therapies.

Language: Английский

Citations

1