A State-of-Art Review of the Vicious Circle of Sleep Disorders, Diabetes and Neurodegeneration Involving Metabolism and Microbiota Alterations DOI Open Access
Salvatore Versace, Gaia Pellitteri,

Roberto Sperotto

et al.

International Journal of Molecular Sciences, Journal Year: 2023, Volume and Issue: 24(13), P. 10615 - 10615

Published: June 25, 2023

In the context of neurodegenerative disorders, cognitive decline is frequently reported in older population. Recently, numerous metabolic pathways have been implicated neurodegeneration, including signaling disruption insulin and other glucose-regulating hormones. fact, Alzheimer's disease has now considered as "type-3 diabetes". this review, we tried to clarify role sleep impairment third major player complex relationship between diseases. Altered may trigger or perpetuate these vicious mechanisms, leading development both dementia type 2 diabetes mellitus. Finally, analyzed reciprocal interactions considering emerging gut microbiota modulating same processes. Conditions dysbiosis linked circadian rhythm disruption, alterations, release neurotoxic products, all contributing neurodegeneration. a future prospective, could provide contribution explaining tangled diabetes.

Language: Английский

Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission DOI
Gill Livingston, Jonathan Huntley, Kathy Liu

et al.

The Lancet, Journal Year: 2024, Volume and Issue: 404(10452), P. 572 - 628

Published: July 31, 2024

Language: Английский

Citations

619
Sodium-glucose cotransporter-2 inhibitors and their potential role in dementia onset and cognitive function in patients with diabetes mellitus: a systematic review and meta-analysis DOI Creative Commons

Y J Youn,

Seung Yeon Kim,

Hyun‐Jeong Jeong

et al.

Frontiers in Neuroendocrinology, Journal Year: 2024, Volume and Issue: 73, P. 101131 - 101131

Published: Feb. 16, 2024

This systematic review and meta-analysis aimed to determine the association between use of sodium-glucose cotransporter 2 (SGLT-2) inhibitors dementia onset as well cognitive function in patients with diabetes mellitus. We comprehensively searched MEDLINE, Embase, CENTRAL databases select relevant studies published up August 2023. The SGLT-2 significantly lowers risk compared SGLT-2i non-users (Hazard ratio: 0.68, 95 % CI: 0.50-0.92). Furthermore, our findings indicated a positive effect inhibitor on score improvement, demonstrated by standardized mean difference 0.88 (95 0.32-1.44), particularly among populations mild impairment or dementia. indicate potential role reducing These underscore need for well-controlled large clinical trials future research this field.

Language: Английский

Citations

24
Impact of Sodium Glucose Cotransporter 2 Inhibitors (SGLT2i) Therapy on Dementia and Cognitive Decline DOI Creative Commons

Antonio Lardaro,

L. Quarta,

Stefania Pagnotta

et al.

Biomedicines, Journal Year: 2024, Volume and Issue: 12(8), P. 1750 - 1750

Published: Aug. 3, 2024

Dementia is an age-related syndrome characterized by the progressive deterioration of cognition and capacity for independent living. Diabetes often associated with cognitive decline shares similar pathophysiological mechanisms dementia, such as systemic inflammation, oxidative stress, insulin resistance, advanced glycation end-products formation. Therefore, adequate diabetes management may reduce risk decline, especially in patients other comorbidities factors. The sodium glucose cotransporter inhibitors (SGLT2i) regulate renal reabsorption blocking SGLT2 cotransporters located proximal tubules, causing glycosuria intraglomerular pressure reduction. Their use helps to lower blood modifying water homeostasis; these drugs are also commonly used treatment heart failure chronic kidney disease, while recently, a potential neuroprotective role central nervous system has been suggested. aim our scoping review analyze current evidence about effects SGLT2i adult patients. We performed literature evaluate effect on mild impairment (MCI) Alzheimer's disease incidence progression. screening process was through different searches PubMed EMBASE, evaluating original works published up January 2024. In conclusion, could be diabetes, reducing or progression MCI dementia. Further prospective studies needed validate this hypothesis effectiveness class normal glycemic profile

Language: Английский

Citations

19
Risk of dementia after initiation of sodium-glucose cotransporter-2 inhibitors versus dipeptidyl peptidase-4 inhibitors in adults aged 40-69 years with type 2 diabetes: population based cohort study DOI Creative Commons
Anna Shin, Bo Kyung Koo,

Jun Young Lee

et al.

BMJ, Journal Year: 2024, Volume and Issue: unknown, P. e079475 - e079475

Published: Aug. 28, 2024

To compare the risk of dementia associated with sodium-glucose cotransporter-2 (SGLT-2) inhibitors versus dipeptidyl peptidase-4 (DPP-4) in adults aged 40-69 years type 2 diabetes.

Language: Английский

Citations

18
Effects of Sodium-Glucose Cotransporter 2 Inhibitors on Nervous System Disorders: A Systematic Review and Meta-Analysis DOI
Bo Xu,

Mingxia Yang,

Shaoqian Li

et al.

Annals of Pharmacotherapy, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 23, 2025

Background: Adults with type 2 diabetes mellitus (T2DM) are at an increased risk for certain brain or psychiatric disorders, as those without chronic kidney disease heart failure. Whether sodium-glucose cotransporter (SGLT2) inhibitors associated these diseases is unclear. Objective: This systematic review and meta-analysis aimed to investigate the effects of SGLT2 on nervous system disorders. Methods: We searched PubMed, ClinicalTrials.gov, Web Science randomized, double-blind placebo-controlled trials least ≥24 weeks. used Mantel–Haenszel statistical method, ratio (RR), 95% confidence interval (CI) dichotomous variables. Results: included 52 publications/trials covering 111 376 participants (SGLT2 62 192; Placebo 49 184). Sodium-glucose had no significant effect ischaemic stroke (RR = 0.97; CI 0.87-1.09; P 0.64), cerebrovascular accident 1.05; 0.91-1.22; 0.50), dementia 1.29; 0.78-2.12; 0.32), carotid artery occlusion/carotid stenosis 1.18; CI: 0.92-1.53; 0.20), haemorrhagic 0.84; 0.62-1.12; 0.23), transient attack 0.82-1.15; 0.73) compared placebo. No heterogeneity was observed. However, showed slight reduce Parkinson’s (major failure subgroup). Empagliflozin dapagliflozin significantly syncope 1.65; 1.15-2.38; < 0.01) 1.04-2.61; 0.03), respectively. Conclusion Relevance: disorders There reduced Disease observed in some specific populations. In addition, risks empagliflozin concerning worth attention.

Language: Английский

Citations

3
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
GLP-1RA and SGLT2i Medications for Type 2 Diabetes and Alzheimer Disease and Related Dementias DOI
Huilin Tang, William T. Donahoo, Steven T. DeKosky

et al.

JAMA Neurology, Journal Year: 2025, Volume and Issue: unknown

Published: April 7, 2025

Importance The association between glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2is) risk of Alzheimer disease related dementias (ADRD) remains to be confirmed. Objective To assess the ADRD associated with GLP-1RAs SGLT2is in people type 2 diabetes (T2D). Design, Setting, Participants This target trial emulation study used electronic health record data from OneFlorida+ Clinical Research Consortium January 2014 June 2023. Patients were 50 years or older T2D no prior diagnosis antidementia treatment. Among 396 963 eligible patients T2D, 33 858 included GLP-1RA vs other glucose-lowering drug (GLD) cohort, 34 185 SGLT2i GLD 24 117 cohort. Exposures Initiation treatment a GLP-1RA, SGLT2i, second-line GLD. Main Outcomes Measures was identified using clinical codes. Hazard ratios (HRs) 95% CIs estimated Cox proportional hazard regression models inverse probability weighting (IPTW) adjust for potential confounders. Results cohort (mean age, 65 years; 53.1% female), 65.8 49.3% 63.8 51.7% female). In IPTW-weighted cohorts, incidence rate lower initiators compared (rate difference [RD], −2.26 per 1000 person-years [95% CI, −2.88 −1.64]), yielding an HR 0.67 (95% 0.47-0.96). had than (RD, −3.05 −3.68 −2.42]), 0.57 0.43-0.75). There SGLT2is, RD −0.09 −0.80 0.63) 0.97 0.72-1.32). Conclusion Relevance both statistically significantly decreased GLDs, observed drugs.

Language: Английский

Citations

2
Diabetes, antidiabetic medications and risk of dementia: A systematic umbrella review and meta‐analysis DOI Creative Commons
Alvin Kuate Defo,

Veselko Bakula,

Alessandro Pisaturo

et al.

Diabetes Obesity and Metabolism, Journal Year: 2023, Volume and Issue: 26(2), P. 441 - 462

Published: Oct. 23, 2023

Abstract Aims The objective of this umbrella review and meta‐analysis was to evaluate the effect diabetes on risk dementia, as well mitigating antidiabetic treatments. Materials Methods We conducted a systematic its treatment, focusing treatment. searched MEDLINE/PubMed, Embase, PsycINFO, CINAHL Cochrane Library for reviews meta‐analyses assessing cognitive decline/dementia in individuals with until 2 July 2023. random‐effects obtain ratios 95% confidence intervals estimating association metformin, thiazolidinediones, pioglitazone, dipeptidyl peptidase‐4 inhibitors, α‐glucosidase meglitinides, insulin, sulphonylureas, glucagon‐like peptide‐1 receptor agonists (GLP1RAs) sodium‐glucose cotransporter‐2 inhibitors (SGLT2is) dementia from cohort/case‐control studies. subgroups analysed included country world region. Risk bias assessed AMSTAR tool Newcastle‐Ottawa Scale. Results 100 27 studies (N = 3 046 661). Metformin, GLP1RAs SGLT2is were associated significant reduction dementia. When examining metformin divided by country, only United States. Moreover, Western but not Eastern populations. No observed or while meglitinides sulphonylureas increased risk. Conclusions reduced More longitudinal aimed at determining their relative benefit different populations should be conducted.

Language: Английский

Citations

32
Risk of Dementia in Patients with Diabetes Using Sodium-Glucose Transporter 2 Inhibitors (SGLT2i): A Systematic Review, Meta-Analysis, and Meta-Regression DOI Creative Commons
Pricilla Yani Gunawan, Paskalis Andrew Gunawan, Timotius Ivan Hariyanto

et al.

Diabetes Therapy, Journal Year: 2024, Volume and Issue: 15(3), P. 663 - 675

Published: Feb. 10, 2024

Dementia is quite prevalent and among the leading causes of death worldwide. According to earlier research, diabetes may increase possibility developing dementia. However, association between antidiabetic agents dementia not yet clear. This investigation examines use sodium-glucose transporter 2 inhibitors (SGLT2i) risk in patients with diabetes. Up April 18, 2023, four databases—Europe PMC, Medline, Scopus, Cochrane Library—were searched for relevant literature. We included all studies that examine adults who SGLT2i. Random-effect models were used compute outcomes this investigation, producing pooled odds ratios (OR) 95% confidence intervals (CI). Pooled data from seven observational revealed SGLT2i was linked a lower people (OR 0.45, CI 0.34–0.61; p < 0.00001, I2 = 97%). The reduction due SGLT2i's neuroprotective effect only significantly affected by dyslipidemia (p 0.0004), but sample size 0.2954), study duration 0.0908), age 0.0805), sex 0.5058), hypertension 0.0609), cardiovascular disease 0.1619), or stroke 0.2734). taking reduces incidence having beneficial impact. Randomized controlled trials (RCTs) are still required order verify findings our research.

Language: Английский

Citations

12
The impact of sodium‐glucose co‐transporter‐2 inhibitors on dementia and cardiovascular events in diabetic patients with atrial fibrillation DOI

Yun‐Yu Chen,

Hao‐Chih Chang, Yenn‐Jiang Lin

et al.

Diabetes/Metabolism Research and Reviews, Journal Year: 2024, Volume and Issue: 40(2)

Published: Feb. 1, 2024

Abstract Aims The effectiveness of sodium‐glucose co‐transporter‐2 inhibitors (SGLT2i) on incident dementia in patients with diabetes and atrial fibrillation (AF) remains unknown. This study aimed to investigate the association between SGLT2i risk diabetic AF, explore interactions oral anticoagulants or dipeptidyl peptidase‐4 (DPP4i). Materials Methods We conducted a cohort using Taiwan's National Health Insurance Research Database. Patients AFwithout prior history established cardiovascular diseases, were identified. Using propensity score matching, 810 receiving matched 1620 not SGLT2i. primary outcome was dementia, secondary outcomes included composite events mortality. Results After up 5 years follow‐up, use associated significantly lower (hazard: 0.71, 95% confidence interval: 0.51–0.98), particularly vascular (HR: 0.44, CI: 0.24–0.82). related reduced risks AF‐related hospitalisation 0.72, 0.56–0.93), stroke 0.75, 0.60–0.94), all‐cause death 0.33, 0.24–0.44). protective effects consistent irrespective concurrent non‐vitamin K antagonist (NOACs) DPP4i. Conclusions In hospitalisation, stroke, death. independent either NOACs

Language: Английский

Citations

11