Ageing Research Reviews, Journal Year: 2023, Volume and Issue: 90, P. 102018 - 102018
Published: July 20, 2023
Language: Английский
Diabetes Care, Journal Year: 2022, Volume and Issue: 45(5), P. 1247 - 1251
Published: March 14, 2022
To assess whether the sodium-glucose cotransporter 2 (SGLT2) inhibitor empagliflozin improves cognitive impairment in frail older adults with diabetes and heart failure preserved ejection fraction (HFpEF).We designed a prospective study to physical function consecutive HFpEF, comparing effects of empagliflozin, metformin, insulin.A total 162 HFpEF successfully completed study. Montreal Cognitive Assessment scores at baseline after 1 month were 19.80 ± 3.77 vs. 22.25 3.27 (P < 0.001) group, 19.95 3.81 20.71 3.56 = 0.26) metformin 19.00 3.71 19.1 0.81) insulin group. A multivariable regression analysis confirmed beneficial empagliflozin. Additionally, we observed marked amelioration impairment, assessed by 5-m gait speed test, groups but not group.This is first show significant SGLT2 on HFpEF.
Language: Английский
Citations
109
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
20
Alzheimer s & Dementia, Journal Year: 2024, Volume and Issue: unknown
Published: Oct. 24, 2024
Abstract INTRODUCTION Emerging preclinical evidence suggests that semaglutide, a glucagon‐like peptide receptor agonist (GLP‐1RA) for type 2 diabetes mellitus (T2DM) and obesity, protects against neurodegeneration neuroinflammation. However, real‐world its ability to protect Alzheimer's disease (AD) is lacking. METHODS We conducted emulation target trials based on nationwide database of electronic health records (EHRs) 116 million US patients. Seven were emulated among 1,094,761 eligible patients with T2DM who had no prior AD diagnosis by comparing semaglutide seven other antidiabetic medications. First‐ever occurred within 3‐year follow‐up period was examined using Cox proportional hazards Kaplan–Meier survival analyses. RESULTS Semaglutide associated significantly reduced risk first‐time diagnosis, most strongly compared insulin (hazard ratio [HR], 0.33 [95% CI: 0.21 0.51]) weakly GLP‐1RAs (HR, 0.59 0.37 0.95]). Similar results seen across obesity status, gender, age groups. DISCUSSION These findings support further studies assess semaglutide's potential in preventing AD. HIGHLIGHTS 40% 70% risks medications, including GLP‐1RAs. lower AD‐related medication prescriptions. reductions Our provide supporting the clinical benefits mitigating initiation development T2DM. delaying or
Language: Английский
Citations
18
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
17
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
2
Biomedicines, Journal Year: 2022, Volume and Issue: 10(5), P. 1168 - 1168
Published: May 18, 2022
The main cause of death in patients with type 2 DM is cardiovascular complications resulting from the progression atherosclerosis. pathophysiology association between diabetes and its vascular complex multifactorial closely related to toxic effects hyperglycemia that causes increased generation reactive oxygen species promotes secretion pro-inflammatory cytokines. Subsequent oxidative stress inflammation are major factors complications. Data on pathogenesis development associated diseases, particular atherosclerosis, open up broad prospects for further new diagnostic therapeutic approaches.
Language: Английский
Citations
48
Diabetes Metabolic Syndrome and Obesity, Journal Year: 2022, Volume and Issue: Volume 15, P. 2583 - 2597
Published: Aug. 1, 2022
Abstract: Diabetes and obesity are growing problems worldwide associated with a range of acute chronic complications, including myocardial infarction (AMI) stroke. Novel anti-diabetic medications designed to treat T2DM, such as glucagon-like peptide-1 receptor agonists (GLP-1RAs) sodium-glucose cotransporter-2 inhibitors (SGLT-2is), exert beneficial effects on metabolism the cardiovascular system. However, underlying mechanisms poorly understood. GLP-1RAs induce anorexic by inhibiting central regulation food intake reduce body weight. Central/peripheral administration inhibits intake, accompanied an increase in c-Fos expression neurons within paraventricular nucleus (PVN), amygdala, solitary tract (NTS), area postrema (AP), lateral parabrachial (LPB) arcuate (ARC), induced activation GLP-1 receptors nervous system (CNS). Therefore, need pass through blood-brain barrier their pharmacological effects. In addition, studies revealed that SGLT-2is could risk heart failure people type 2 diabetes. SGLT-2 is extensively expressed throughout CNS, was also observed hours mice. Recent clinical reported improved hypertension atrial fibrillation modulating “overstimulated” renin-angiotensin-aldosterone (RAAS) suppressing sympathetic (SNS) directly/indirectly acting rostral ventrolateral medulla. Despite extensive research into mechanism SGLT-2is, penetration (BBB) remains controversial. This review discusses interaction between BBB via CNS. Keywords: system, medications,
Language: Английский
Citations
44
Theranostics, Journal Year: 2023, Volume and Issue: 13(14), P. 4872 - 4884
Published: Jan. 1, 2023
Reactive oxygen species (ROS) have emerged as essential signaling molecules regulating cell survival, death, inflammation, differentiation, growth, and immune response.Environmental factors, genetic or many pathological condition such diabetes increase the level of ROS generation by elevating production advanced glycation end products, reducing free radical scavengers, increasing mitochondrial oxidative stress, interfering with DAG-PKC-NADPH oxidase xanthine pathways.Oxidative therefore accumulation intracellular ROS, determines deregulation several proteins caspases, damages DNA RNA, interferes normal neuronal function.Furthermore, play an role in polymerization, phosphorylation, aggregation tau amyloid-beta, key mediators cognitive function decline.At level, interfere methylation pattern various apoptotic factors related to promoting neurodegeneration.Only few drugs are able quench neurons.The cross-linking pathways between dementia suggest that antidiabetic medications can potentially treat dementia.Among drugs, glucagon-like peptide-1 receptor agonists (GLP-1RAs) been found reduce ameliorate function, protein aggregation, neuroinflammation, synaptic plasticity, learning, memory.The incretin hormone (GLP-1) is produced enteroendocrine L cells distal intestine after food ingestion.Upon interacting its (GLP-1R), it regulates blood glucose levels inducing insulin secretion, inhibiting glucagon production, slowing gastric emptying.No study has evidenced a specific GLP-1RA pathway quenches production.Here we summarize effects GLP-1RAs against overproduction discuss putative efficacy Exendin-4, Lixisenatide, Liraglutide treating decreasing ROS.
Language: Английский
Citations
24
Frontiers in Public Health, Journal Year: 2023, Volume and Issue: 11
Published: March 6, 2023
It is reported that insulin resistance widely exists in non-diabetic patients with a recent history of transient ischemic attack (TIA) or stroke. There currently strong evidence to prove the bidirectional effect glucose metabolism disorders and stroke events. Therefore, it necessary retrospectively tease out current status, hotspots, frontiers cerebrovascular disease through CiteSpace.We searched Web Science (WOS) for studies related from 1999 April 2022, then downloaded data into CiteSpace generate knowledge visualization map.A total 1,500 publications relevant were retrieved. The USA had most articles on this topic, followed by PEOPLES R CHINA JAPAN. WALTER N KERNAN was prolific author, whose research mainly focused intervention after (IRIS) trial. common keywords myocardial ischemia, metabolic syndrome, stroke, cerebral association, oxidative stress, inflammation, adipose tissue. Major ongoing trends include three aspects: (1) association between patients, (2) intrinsic pathological mechanism disease, (3) early improve prognosis stroke.The results bibliometric study provide status clinical field disease. Insulin strongly associated occurrence neurological deterioration post-stroke depression, small vessel Early treatment can be an effective way prevent onset prognosis. This may help researchers identify hot topics explore new directions.
Language: Английский
Citations
22
Biomedicines, Journal Year: 2024, Volume and Issue: 12(1), P. 99 - 99
Published: Jan. 3, 2024
Type 2 diabetes mellitus (T2DM) and Alzheimer’s disease (AD) are chronic, progressive disorders affecting the elderly, which fosters global healthcare concern with growing aging population. Both T2DM AD have been linked increasing age, advanced glycosylation end products, obesity, insulin resistance. Insulin resistance in periphery is significant development of it has posited that brain plays a key role pathogenesis, earning name “type 3 diabetes”. These clinical epidemiological links between become increasingly pronounced throughout years, serve as means to investigate effects antidiabetic therapies AD, such metformin, intranasal insulin, incretins, DPP4 inhibitors, PPAR-γ agonists, SGLT2 inhibitors. The majority these drugs shown benefit preclinical trials, some promising results improvement cognitive faculties participants mild impairment AD. In this review, we summarize benefits, risks, conflicting data currently exist for diabetic being repurposed treatment
Language: Английский
Citations
15