Jun 24, 2015

Diabetes medication reduces risk of dementia

Treating people with type 2 diabetes, also known as "age-related diabetes" with anti diabetics reduces their risk for Alzheimer’s and other types of dementia.

Diabetes medication reduces risk of dementia

The risk is most significantly reduced by the drug pioglitazone. Researchers of the German Center for Neurodegenerative Diseases (DZNE) draw this conclusion from an analysis of health insurance data.

Their findings are published in the journal Annals of Neurology.

Alzheimer's Disease Study | Alzheimer's Reading Room

Alzheimer's Reading Room
  • Patients with type 2 diabetes have a dysfunctional sugar metabolism because the essential hormone insulin does not work effectively.
  • Once the disease reaches an advanced stage, the body stops producing insulin altogether, which means that it has to be administered externally. 
  • Type 2 diabetes most commonly occurs in late adulthood, and it has long been known that it can affect the patient's mental health: Patients have a greater risk of developing dementia than non-diabetics. 
Neurologist Michael Heneka and the demographers Anne Fink and Gabriele Doblhammer investigated this issue in the current study. Their work is based on data from the years 2004 to 2010 provided by the German public health insurance company AOK. These data set comprises information about diseases and medication related to more than 145,000 men and women aged 60 and over.

Long-term treatment reduced dementia risk

The analysis confirmed previous findings that diabetics have an increased risk of developing dementia.
  • However, it was also found that this risk can significantly be modified by pioglitazone. This drug is taken as tablets. It is applied in short-term as well as in long-term treatment of diabetes as long as the body is still capable of producing its own insulin.


Important warning:

Pioglitazone and other similar medications for diabetes may cause or worsen congestive heart failure (condition in which the heart is unable to pump enough blood to the other parts of the body). Before you start to take pioglitazone, tell your doctor if you have or have ever had congestive heart failure, especially if your heart failure is so severe that you must limit your activity and are only comfortable when you are at rest or you must remain in a chair or bed.

Also tell your doctor if you were born with a heart defect, and if you have or have ever had swelling of the arms, hands, feet, ankles, or lower legs; heart disease; high cholesterol or fats in the blood; high blood pressure; coronary artery disease (narrowing of the blood vessels that supply blood to the heart); a heart attack; an irregular heartbeat; or sleep apnea. Your doctor may tell you not to take pioglitazone or may monitor you carefully during your treatment.

Source of this information - Pioglitazone U.S. National Library of Medicine.


"Treatment with pioglitazone showed a remarkable side benefit. It was able to significantly decrease the risk of dementia," says Doblhammer. "The longer the treatment, the lower the risk."

Risk reduction was most noticeable when the drug was administered for at least two years. Diabetics given this treatment developed dementia less often than non-diabetics. Doblhammer: "The risk of developing dementia was around 47 percent lower than in non-diabetics, i.e. only about half as large."

Metformin – another frequently prescribed antidiabetic drug – also lowered the risk of developing dementia. However, the effect was lower than that of pioglitazone.

Protection against nerve cell damage

Pioglitazone improves the effect of the body’s own insulin. Moreover, laboratory tests have long indicated that it also protects the nerve cells.

 "Our study suggests that pioglitazone has a preventive effect. This happens when the drug is taken before symptoms of dementia manifest. Thus, it protects in particular against Alzheimer's, the most common form of dementia. The causes for this, whether pioglitazone only has this protective effect in diabetics or if it would also work in non-diabetics – all these questions have yet to be answered. The next logical step would therefore be clinical studies. These studies would specifically investigate the effect of pioglitazone and other antidiabetics on dementia."

Original publication
Effect of pioglitazone medication on the incidence of dementia
Michael T. Heneka, Anne Fink, Gabriele Doblhammer.
Annals of Neurology 2015, doi: 10.1002/ana.24439


These findings indicate that pioglitazone treatment is associated which a reduced dementia risk in initially non-insulin dependent diabetes mellitus patients. Prospective clinical trials are needed to evaluate a possible neuroprotective effect in these patients in an ageing population.

You are reading original content the Alzheimer's Reading Room