A commonly used type 2 diabetes drug may lower the risk of dementia, a study suggests.
Diabetes has long been linked to an increased risk of dementia, which is thought to be due to low blood sugar levels damaging parts of the brain, as has the link between diabetes and high blood pressure.
Scientists in South Korea found a link between the use of pioglitazone – sold under the brand name Actos – and lower rates of dementia in type 2 diabetes.
The study followed 91,000 adults in their 60s, including 3,500 who took the drug, for 10 years. The longer patients took the drug, the lower their risk of dementia.
Those who took the drug for more than four years seemed to be 37 percent less likely to be diagnosed with the condition.
Scientists suggest that the diabetes drug pioglitazone — sold under the brand name Actos — may reduce a patient’s risk of dementia. It has long been known that diabetes increases this risk
The study was only able to detect a correlation and could not prove that pioglitazone reduced the risk of dementia in patients.
Pioglitazone is available by prescription for type 2 diabetes patients.
It is prescribed to approximately 3 million Americans and over a million Britons each year.
Previous studies have also linked the drug to a reduced risk of dementia and even suggested it may help prevent hospitalization and death from Covid.
Pioglitazone has been available since 1985.
Doctors often prescribe the drug in addition to a healthier diet and exercise, to further increase the body’s sensitivity to insulin.
It works by increasing the body’s sensitivity to insulin, a natural substance that helps control blood sugar levels.
In the latest study, researchers at Yonsei University in Seoul analyzed diabetes data from a national health database for people newly diagnosed with diabetes between 2002 and 2017.
They contain data from 91,218 people, 3,467 of whom were prescribed pioglitazone.
The patients were about 60 years old on average, and none had dementia when their diabetes was diagnosed.
The results showed that of those prescribed pioglitazone, eight percent later developed dementia.
In comparison, in the group not prescribed the drug, 10 percent developed the debilitating condition.
After adjusting for factors such as high blood pressure, smoking and physical activity, they found that people who took the drug were 16 percent less likely to get the disease compared to those who didn’t.
The length of time a person was on the drug seemed to further reduce the risk.
Participants who took pioglitazone for one to two years had a 22 percent lower risk of dementia.
But among those who took the pills for four years or more, they were 37 percent less likely to develop the debilitating disease.
The study also found that participants with a history of heart disease or stroke who took the drug were 54 percent and 43 percent, the scientists found.
Scientists warned patients with diabetes not to rush all of them to take the drug, as it can cause serious side effects. These include weight gain, bone loss, and congestive heart failure.
Dr. Eosu Kim, a psychiatrist at Yonsei University who led the study, said: ‘As dementia develops years before it is diagnosed, there may be an opportunity to intervene before it progresses.
“These results may suggest that we can use a personalized approach to prevent dementia in people with diabetes in case they have a history of ischemic heart disease or stroke.”
She added: ‘In some previous studies of people with dementia or at risk of cognitive decline who did not have diabetes, pioglitazone did not show any protection against dementia.
“So it’s likely that a critical factor influencing effectiveness is the presence of diabetes.”
Scientists suggested that diabetes increases the risk of dementia through several mechanisms.
It is already known to increase the risk of heart disease and high blood pressure, making someone more likely to have a stroke – a risk factor for dementia.
Low blood sugar episodes are also known to increase the risk of dementia because they can lead to damage to the hippocampus, the area of the brain dedicated to memory.
Previous studies also warn that insulin plays a role in the amount of beta-amyloid accumulated in the brain, a cause of dementia.
The scientists cautioned that the paper had several limitations, including that it was based on insurance claims, meaning some people who bought the drug themselves would not have been included in the data.
It was also possible that patients were not using the drug as prescribed.
The study was funded by the Korean Ministry of Health and Welfare and the National Research Foundation of Korea.
It was published in the journal Neurology, the medical journal of the American Academy of Neurology.
What is Pioglitazone?
Pioglitazone is a prescription drug for diabetic patients to control their blood sugar levels.
In the United States, it is sold under the Actos brand name.
It works by making cells more responsive to insulin,
How is the drug prescribed?
Doctors will prescribe one pill to be taken orally with water every day.
It can be taken with or without food.
Diabetes patients who receive the drug are usually put on it for life.
Some medical organizations may also prescribe the drug with a plan to improve a patient’s exercise and diet.
Are there side effects?
Doctors warn that side effects of the drug include swelling, weight gain, bone loss and congestive heart failure.