Type 2 diabetes drug associated with 35% lower risk of dementia, study finds

https://www.theguardian.com/society/article/2024/aug/28/type-2-diabetes-drug-associated-with-35-lower-risk-of-dementia-study-finds

by monkey_monkey • 2 years ago

118 42 2 years ago

theguardian.com

chiefalchemist3• 2 years ago

The smarter way to look at it: Diabetes increases the chances of dementia. It's diabetes that's causing an unnatural increase. Rhe drug is simply a catalyst for something closer to normal. Obesity at it's current rate, while socially normalized, is from an evolutionary standpoint abnormal.

vessenes• 2 years ago

The article mentions that this effect was seen in only the cohort taking one of two prevalent diabetes medications.

For your interpretation to be accurate, you’d need to also show that the other popular medicine doesn’t work for diabetes type 2 treatment.

FWIW, the last line of the article is a dismissal from a UK doctor saying that this would make the diabetes drug better than any existing Alzheimer treatments, and suggesting that there’s a confounding variable in the study instead.

yieldcrv2• 2 years ago

or the Alzheimer’s treatments aren’t treating sugar buildup as amyloid plaques, and instead are trying to manage Alzheimer symptoms

But I don't know though

giantg2• 2 years ago

"For your interpretation to be accurate, you’d need to also show that the other popular medicine doesn’t work for diabetes type 2 treatment."

This is not true. It's possible that there are multiple effects of type 2 diabetes, with multiple drugs that treat the main factor (sugar levels), but with a subset of the drugs affecting other factors (hormones, cellular activities, something else) that influence dementia.

madmads• 2 years ago

The smarter way to comment online: Read the article before commenting on how to best understand it. As the other reader mentioned, that's not what the article says.

chiefalchemist3• 2 years ago

So be complicit in the article's false paradigm?

That is, the medication doesn't improve anything per se. The problem is obesity and diabetes. The medication does not perform better than these not being present at all.

The presume diabetes - sans T1 - is a norm is false if not dangerous. In other words, "Sure just throw more meds at it" is not a narrative anyone should be comfortable with.

nabla9• 2 years ago

Look up "confounding variable" and think again https://en.wikipedia.org/wiki/Confounding

What you describe is not smarter way. It's jumping to conclusions.

chiefalchemist3• 2 years ago

No actually, I'm not. Instead, my baseline is the historic norm, the evolutionary norm. I don't jump to the conclusion of normalizing diabetes and then come up with some throw-more-pills-at-it theory.

In other words, how effective is this "cure" vs no diabetes at all? *That* is the question.

InDubioProRubio2• 2 years ago

From an evolutionary standpoint, animals cycle from obese to slim year round. Obesity is normal in autumn. Being slim is normal in spring/early summer. Food state wise we are in a eternal autumn.

chmod775• 2 years ago

There's no "normal" obesity or time when obesity is normal. The disease is characterized by an abnormal weight by definition.

An animal who has a normal weight for one of its species at some time of year is not obese.

inglor_cz• 2 years ago

This only really applies to some animals which developed in moderate climate.

Most primates including us humans are tropical and subtropical creatures, which didn't face classical winters until relatively recently. The Neanderthals did, for a considerable amount of time, and their physiology might have been different, but the Neanderthals were also developed enough to protect themselves using clothing and shelters, and possibly store food, so physiological adjustments might not have been necessary.

Modern humans are basically Africans adapted to ~ Kenyan climate, though. (Yeah I know about the Neanderthal and Denisovan admixture.)

moi2388• 2 years ago

From an evolutionary standpoint, like bears, we only managed to survive long enough for our offspring to have offspring, which is all that matters for evolution.

I never understood why these references are being made regarding health.

Bears aren’t healthy. Bears don’t live long. Ancient people weren’t healthy, their diets weren’t healthy and they had lots of untreated issues as well.

hi-v-rocknroll• 2 years ago

Article:

- SGLT-2 inhibitors: canagliflozin, dapagliflozin, sotagliflozin, bexagliflozin

- DPP-4 inhibitors: sitagliptin, saxagliptin, linagliptin

Other beneficial drugs beyond/with/for diabetes and/or weight:

- Metformin

- AGIs: acarbose

- GLP-1 agonists: tirzepatide, semaglutide, liraglutide

- DACRAs: cagrilintide

Maybe in the future it will be possible to manage a person's glucose and related hormone levels in roughly a continuous keto or borderline low blood sugar state using the equivalent of an "insulin pump" and a real-time blood glucose monitor control system such that it doesn't promote low-blood sugar neurological symptoms.

code_duck3• 2 years ago

That’s already the concept of insulin pumps. The problem currently is that subcutaneous insulin takes too long to work to be very precise, and also, pumps don’t have a concept of carb intake. They try to predict whether automatic doses are need based on trends. Also, typical blood glucose for a non-diabetic person is 85 mg/dL. This is fairly close to the line of hypoglycemia, which is under 70, so automated pumps aim to keep glucose somewhat higher. For the Tandem T:Slim, it attempts to maintain 110, for instance. I am not familiar with most of the drugs listed there but I suspect their action would be far too slow to work very well in that regard.

hungie• 2 years ago

Could we, for instance, develop a glucose fuel cell that turns the excess glucose into electricity or heat to remove it?

I could imagine that being responsive, and toggleable.

je422• 2 years ago

I have Type 1 Diabetes (T1D) and use a semi-closed loop system, which includes the Libre 2 sensor with XDrip and the Omnipod Dash, managed by AAPS.

AAPS (unlike the Tandem T , which I’m less familiar with) uses a more sophisticated algorithm to calculate the required insulin, considering several factors:

- Blood sugar levels received via XDrip from the Libre 2 sensor.

- A profile that includes:

- - The basal rate per hour for each time slot

- - The insulin-to-carb ratio

- - The target blood sugar range

- Automatically calculated insulin sensitivity.

- Insulin on board (remaining active insulin), calculated using a curve to estimate how much insulin is still active after injection.

- Carbs on board, with AAPS tracking active carbs over time.

UniverseHacker2• 2 years ago

People in ketosis actually have higher fasting blood sugar than those on high carb diets- there is an adaptive insulin resistance that preserves glucose for the brain and heart cells that can’t survive without it.

That said- it is an adaptive mechanism that is rapidly reversible, and totally different from type II diabetic insulin resistance.

something98• 2 years ago

there is an adaptive insulin resistance that preserves glucose for the [specific] brain and heart cells that can’t survive without it.

To be clear, most brain and heart cells do not require glucose to function. Although, a small subset do.

rawicki• 2 years ago

DPP-4 drugs are less effective also on other metrics. Would be far more interesting to see the comparison of SGLT-2 inhibitors vs GLP-1 agonists.

For some reason GLP-1 drugs are not that popular in Korea (and still not prescribed just for the weight loss), so that may explain why these researchers haven't done that.

tsoukase• 2 years ago

Diabetes is a debilitating situation. A slow killer. It is an independent factor for both degenerative (Alzheimer's) and vascular dementia. I do not think any drug will be better than the disease itself. On the other side, if we use a diabetes drug to cure dementia in non-diabetes patients, we might have a good result but with hypoglycemia as a side effect.

jjallen• 2 years ago

For non-diabetics this is fairly easy to prevent (at least it is for me). You just eat a moderate amount of food before taking it (referring to metformin).

zug_zug• 2 years ago

In people with diabetes.

tracker1• 2 years ago

Considering that Alzheimers itself is considered type 3 diabetes and Dementia is heavily correlated, it isn't that surprising.

My own PoV is that a lot of it comes down to the massive increase in heavily refined foods and seed oils in the past century and a half. You have a lot of carbs and a really different mix of fatty and amino acids. So higher blood glucose, more of the time combined with a very different mix of fatty and even amino acids in the diet. Likely exacerbated by half a century of low-fat, low cholesterol diets perpetuated largely in busted myth. Combine this with hyper-palatability and it's just hard to get away from.

Heart disease, alzheimer's, dementia, diabetes, obesity... All of it comes down to food and exercise. With a bit more exposure from RFKjr, it's ironic that Time magazine is now doubling down for the conglomerates, can't find the cover photo for this, but the recent article on why ultra-processed foods aren't that bad is astounding.

kranke155• 2 years ago

they made an article on ultra processed foods being ok for you?? Nuts.

mgarfias• 2 years ago

Mom has the dementia and I have t2d. I started looking and discovered one of the meds I’m on already is one of these sglt-2 deals. So yay!

Type 2 diabetes drug associated with 35% lower risk of dementia, study finds

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