Study Finds People Taking the Drugs Have Fewer Biomarkers, Slower Cognitive Decline
From:
American Academy of Neurology
August 11,2021 --MINNEAPOLIS – People
taking certain drugs to lower blood sugar for type 2 diabetes had less amyloid
in the brain, a biomarker of Alzheimer’s disease, when compared to both people
with type 2 diabetes not taking the drugs and people without diabetes. The new
study, published in the August 11, 2021, online issue of Neurology®, the medical journal of the American
Academy of Neurology, also found people taking these drugs, called dipeptidyl
peptidase-4 inhibitors, showed slower cognitive decline than people in the
other two groups.
In people with type 2 diabetes, the body
no longer efficiently uses insulin to control blood sugar. Dipeptidyl
peptidase-4 inhibitors, also known as gliptins, can be prescribed when other
diabetes drugs do not work. They help control blood sugar when combined with
diet and exercise.
“People with diabetes have been shown to
have a higher risk of Alzheimer’s disease, possibly due to high blood sugar
levels, which have been linked to the buildup of amyloid beta in the brain,”
said study author Phil Hyu Lee, MD, PhD, of Yonsei University College of
Medicine in Seoul, South Korea. “Not only did our study show that people taking
dipeptidyl peptidase-4 inhibitors to lower blood sugar levels had less amyloid
in their brains overall, it also showed lower levels in areas of the brain
involved in Alzheimer’s disease.”
The study involved 282 people with an
average age of 76 who were followed up to six years. All had been diagnosed
with either pre-clinical, early or probable Alzheimer’s disease. Of the group, 70
people had diabetes and were being treated with dipeptidyl peptidase-4
inhibitors, 71 had diabetes but were not being treated with the drugs and 141
did not have diabetes. Those without diabetes were matched to those with
diabetes for age, sex, and education levels. All had similar scores on
cognitive tests at the start of the study.
Participants had brain scans to measure
the amount of amyloid in the brain.
Researchers found that people with
diabetes who took the drugs had lower average amounts of amyloid plaques in the
brain compared to people with diabetes who did not take the drugs and compared
to people who did not have diabetes.
All participants took a common thinking
and memory test called the Mini-Mental State Exam (MMSE) on average, every 12
months for 2.5 years. Questions include asking a person to count backward from
100 by sevens or copying a picture on a piece of paper. Scores on the test
range from zero to 30. Researchers found that people with diabetes who took the
drugs had an average annual decline of 0.87 points on their MMSE score, while
people with diabetes who did not take the drugs had an average annual decline
of 1.65 points. People without diabetes scored an average annual decline of
1.48 points.
When researchers adjusted for other factors
that could affect test scores, they found that the scores of the people taking
the drug declined by 0.77 points per year more slowly than the people who did
not take the drug.
“Our results showing less amyloid in the
brains of people taking these medications and less cognitive decline, when
compared to people without diabetes raises the possibility that these
medications may also be beneficial for people without diabetes who have
thinking and memory problems,” said Lee. “More research is needed to demonstrate
whether these drugs may have neuroprotective properties in all people.”
A limitation of the study was that data
were not available to show the accumulation of amyloid in participants’ brains
over time. This study does not show cause and effect. It only shows an
association.
The study was supported by the Korean
Healthy Industry Development Institute and the Korean Ministry of Health &
Welfare.
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