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Some Diabetes Drugs May Help Reduce The Risk Of Alzheimer’s, Study

Diabetes is a lifelong disease in which people with the condition are often prescribed medications to manage their condition followed by strict lifestyle regimes.

Recently, a study published in the journal of the American Academy of Neurology says that the consumption of diabetes medications or drugs to lower glucose levels in type 2 diabetes is associated with less amyloid in the brain, which is a biomarker of Alzheimer's disease. [1]

The comparison was made between type 2 diabetics taking the drugs, type 2 diabetics not taking the drugs and people without diabetes.

Let's know more in detail

How Are Diabetes And Alzheimer's Linked?

According to a study, both diabetes and Alzheimer's diseases (AD) are related to age, and within the last 10 years, there has been an interesting link developed between the two of them in many studies, leading to a new term called "type 3 diabetes" that defines insulin resistance-induced AD. [2]

Another study also agrees with the fact that people with diabetes are at double risk of Alzheimer's compared to non-diabetics. [3]

The key risk factors that have been identified in these studies are: insulin resistance and inflammatory signalling pathways.

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1. Insulin resistance

Insulin resistance leads to decreased production of insulin in the body. Insulin is a hormone that helps signal the brain to take up glucose and produce insulin-degradation enzymes (IDE) to reduce the levels of sugar in the body. Also, it helps promote the clearance of amyloid beta from the brain.

When IDE production is lowered due to insulin resistance, the degradation of amyloid beta is also reduced, causing the abnormal accumulation of amyloid in the brain, thus leading to Alzheimer's. [4]

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2. Inflammatory cytokines

Both diabetes and Alzheimer's are mainly the result of inflammation. Insulin hormones help in the suppression of inflammatory cytokines due to their anti-inflammatory effect and prevent the risk of diabetes complications like Alzheimer's.

However, insulin resistance increases the levels of inflammatory cytokines such as IL-6 and C-reactive protein in the body that may cause the deposition of plaque in the brain along with the progression of Alzheimer's disease. [5]

How Do Oral Diabetes Drugs Prevent Alzheimer's?

Dipeptidyl peptidase-4 inhibitors (DPP-4) are a class of oral diabetes medicines known by the name gliptins. It includes drugs like sitagliptin, linagliptin, saxagliptin and alogliptin. They are FDA-approved medications often prescribed to adults with type 2 diabetes. [6]

The DPP-4 inhibitor drugs act on incretin hormones in the body which are gut peptides secreted after the consumption of food and helps stimulate insulin secretion and maintaining glucose homeostasis or balance of glucose in the body.

The two main incretin hormones on which these drugs act are GLP-1 (glucagon-like peptide-1) and GIP (gastric inhibitory peptide). [7]

1. GLP-1 is secreted by enteroendocrine L cells of the small intestine and serves three main purposes. It helps

  • reduce glucose levels by secreting the insulin in the blood,
  • reduces glucagon hormone concentration so that stored glucose from the liver is not released, and
  • delays gastric emptying (time taken by food to empty from stomach to small intestine) and prevents sudden rise of glucose.

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2. On the other hand, GIP, along with stimulating insulin, helps in the growth and survival of pancreatic beta cells and breaking down fats in the body. [8]

This is how DPP-4 oral diabetes drugs help in maintaining diabetes and preventing its complications like obesity and heart diseases, along with other therapeutic benefits.

Other Anti-Diabetic Drugs That May Help Prevent Alzheimer's

1. Metformin

Metformin is the commonly prescribed diabetes drug that helps lower glucose levels by suppressing the inflammatory cytokines, increasing intestinal glucose use, preventing the blood clots and breaking down cholesterol. A study has shown that people with diabetes and Alzheimer's who are under antidiabetic drugs including metformin have lesser cognitive impairment compared to patients who are untreated. [9]

2. Intranasal insulin

Intranasal insulin helps deliver the insulin quickly to the central nervous system and helps lower the glucose levels, compared to intravenous insulin administration. A study says that intranasal insulin can help improve attention and delay memory and cognitive impairment in people with early Alzheimer's. [10]

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3. Thiazolidinediones

They are other diabetes drugs that may help control glucose levels in diabetics and reduce insulin resistance and inflammation, which are biomarkers of Alzheimer's. A study has shown that individuals receiving the drug have shown improved memory and attention, along with improvement in cognition in patients with both diabetes and AD. [11]

To Conclude

Diabetes drugs not only help prevent Alzheimer's or delay its progression, but are also associated with a lower risk of dementia, a general term for memory loss and impairment of cognitive functions that may affect the day-to-day lives of people.

Story first published: Saturday, August 21, 2021, 8:30 [IST]