People with Type II diabetes have a higher risk of dementia and Alzheimer’s (https://pubmed.ncbi.nlm.nih.gov/16246041/). However, recent studies from South Korea reported that some diabetic drugs appear to help those with mild cognitive issues.
South Korea Study
https://www.newsmax.com/health/health-news/diabetes-medicine-alzheimers/2021/08/13/id/1032193/. The August 11, 2021, online issue of Neurology conveyed new information about Alzheimer’s disease and dipeptidyl peptidase-4 inhibitor diabetes drugs. Almost 300 older Koreans (average age 76) were diagnosed with pre-clinical, early, or probable Alzheimer’s disease. About one-quarter of this group had type II diabetes. Over seven years, the group taking DDP4 diabetes drugs had fewer amyloid-beta plaques in their brains.
https://www.sciencedaily.com/releases/2021/08/210811175221.htm. The diabetic patients had less amyloid plaque in their brains and less cognitive decline. The Mini-Mental State Exam (MMSE) was used to evaluate the participants.
The diabetic group averaged an annual decline of 0.87 points compared to the group not taking any diabetic drugs that registered 1.65 points per year decrease – double the drop of the diabetic group. Those in the group who did not have diabetes and were not taking any drugs for diabetes exhibited an annual decline of 1.48 points per year.
The MMSE was administered several times and had the participants count backward from one hundred by sevens or copy a picture on a blank page.
People with diabetes are resistant to insulin. Alzheimer’s patients have problems with insulin resistance. Animal studies with DDP4 drugs show brain inflammation reduced, another factor in the progression of Alzheimer’s disease.
The drugs noted in the study were sitagliptin (Januvia), linagliptin (Tradjenta), saxagliptin (Onglyza), and alogliptin (Nesina). These drugs boost blood levels of GLP-1 (glucagon-like peptide-1) agonists. An agonist is a chemical molecule that binds to a receptor and stimulates that receptor to generate a biological response instead of an antagonist that blocks the specific biological response. GLP-1 boosts insulin production.
Recently amyloid-beta plaques could only be determined at autopsy by microscopic analysis. However, the amyloid PET scan clearly shows the presence of amyloid plaques. https://radiology.ucsf.edu/patient-care/services/specialty-imaging/alzheimer.
This is a significant advance forward in the diagnosis of Alzheimer’s disease. A fully randomized, placebo-controlled clinical trial could lend more credence to the remarkable results seen in South Korea. Scientists are planning future studies.
Will these drugs work on people without diabetes? Time will tell. Will existing drugs be repurposed to treat Alzheimer’s disease? Most probably. Scientists can only state that there was less amyloid plaque present in the brains of those on the diabetic DDP4 drugs. However, they cannot unequivocally tell us that it was caused by the DDP4 drugs – it is an association (correlation) until more clinical testing is done.
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