Peninsula Clinical School, Central Clinical School, Monash University, 2 Hastings Road, Frankston, VIC, 3199, Australia.
Departments of Medicine and Geriatric Medicine, Peninsula Health, 2 Hastings Road, Frankston, VIC, 3199, Australia.
Curr Neurol Neurosci Rep. 2019 Jul 12;19(8):58. doi: 10.1007/s11910-019-0973-4.
Type 2 diabetes (T2D) is a well-established risk factor for the development of dementia. Dementia and T2D share some underlying pathophysiology that has led to interest in the potential to repurpose drugs used in the management of T2D to benefit brain health. This review describes the scientific data available on the use of T2D medications for the risk reduction or management of dementia, in people with and without T2D.
Results from basic laboratory research support the potential for commonly-used medications for T2D, including those with direct glucose-lowering properties, to have a beneficial effect on brain health. However, human studies have been mostly observational in nature and report conflicting results. Preliminary data suggest that intranasal insulin, metformin, and GLP-1 agonists show promise for dementia, but confirmatory evidence for their benefit in dementia is still lacking. Current evidence does not support the repurposing of T2D medications for dementia risk reduction or management. Research in the field of T2D and dementia is active, and further data are required before definitive conclusions can be drawn.
2 型糖尿病(T2D)是痴呆发生的一个明确的危险因素。痴呆和 T2D 有一些共同的潜在病理生理学,这使得人们对重新利用 T2D 治疗药物以促进大脑健康的潜力产生了兴趣。本综述描述了在有或没有 T2D 的人群中,使用 T2D 药物降低痴呆风险或进行管理的可用科学数据。
基础实验室研究的结果支持了常用 T2D 药物,包括具有直接降血糖特性的药物,对大脑健康可能产生有益的影响。然而,人体研究大多是观察性的,报告的结果相互矛盾。初步数据表明,鼻内胰岛素、二甲双胍和 GLP-1 激动剂在痴呆方面有一定前景,但仍缺乏它们对痴呆有益的确证性证据。目前的证据并不支持重新利用 T2D 药物来降低痴呆风险或进行管理。T2D 和痴呆领域的研究非常活跃,在得出明确结论之前,还需要更多的数据。