The older type 2 diabetes[1] drug pioglitazone[2] (originally sold as Actos) may help protect against dementia[3] in people who take it for blood glucose control[4], according to a new study published in the journal Neurology[5].
People with diabetes are known to be at higher risk for dementia[6], or advanced cognitive impairment. There are ways that you may be able to reduce your risk for dementia[7], though — starting with optimizing your blood glucose control. Certain groups of diabetes drugs[8] may help reduce your dementia risk, including metformin[9]. Lifestyle factors may also play a role[10] in preventing dementia — studies have shown that a higher daily step count[11], a higher intake of antioxidants[12], a healthy body weight[13], and good oral health[14] are all linked to a lower dementia risk.
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For the latest study, researchers looked at the risk of developing dementia in a group of adults with newly diagnosed type 2 diabetes. A total of 91,218 participants with diabetes in the Korean National Health Insurance system were included in the study, and 3,467 of these participants took the drug pioglitazone. Participants were followed for an average of about 10 years between 2002 and 2017, as noted in a press release[16] on the study.
The researchers found that 8.3% of participants who took pioglitazone developed dementia during the follow-up period, compared with 10.0% of those who did not take the drug. After adjusting for a variety of factors that can affect the risk of developing dementia — including blood pressure[17], smoking status[18], and physical activity levels[19] — the researchers found that participants who took pioglitazone were 16% less likely to develop dementia than those who did not take the drug. What’s more, participants who took it for a longer duration saw a greater reduction in dementia risk — those who took it for one to two years were 22% less likely to develop dementia, while those who took it for four years were 37% less likely to develop dementia.
“These results may suggest that we could use a personalized approach to preventing dementia in people with diabetes,” said study author Eosu Kim, MD, PhD, a professor of psychiatry at Yonsei University in Seoul, South Korea, in the press release. “Since dementia develops for years before diagnosis, there may be an opportunity for intervening before it progresses.”
Since this study was based on insurance claims, it’s possible that some people picked up a pioglitazone prescription but didn’t take it — which would, of course, call the study results into question. But it’s unlikely that someone would do this repeatedly for years, and people who filled pioglitazone prescriptions for the longest periods of time had the lowest risk for dementia, which suggests that this lower dementia risk was actually a result of taking the drug.
Kim noted that some previous studies have shown that pioglitazone did not help slow or prevent cognitive decline in people without diabetes, which suggests that the drug is only likely to be beneficial in people with diabetes. More studies are needed, he said, to confirm the latest findings.
Want to learn more about maintaining cognitive health with diabetes? Read “Seven Ways to Ward Off Dementia,”[20] “Nine Tips to Keep Your Memory With Diabetes,”[21] “Keeping Your Brain Strong With Diabetes”[22] and “Memory Fitness: How to Get It, How to Keep It.”[23]
Living with type 2 diabetes? Check out our free type 2 e-course![24]
Source URL: https://www.diabetesselfmanagement.com/news-research/2023/03/15/diabetes-drug-pioglitazone-may-help-protect-against-dementia/
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