Cognitive and metabolic outcomes of vildagliptin addition to the therapy in patients with type 2 diabetes mellitus: 26 week follow-up study

Bulut, Esra Ateş; Alak, Zehra Yağmur Şahin; Dokuzlar, Özge; Koçyiğit, Süleyman Emre; Soysal, Pınar; Smith, Lee; Işık, Ahmet Turan

doi:10.1016/j.archger.2020.104013

Cited by 21 publications

(9 citation statements)

References 35 publications

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“…Among the eight trials included in the present meta‐analysis, the results of six trials 17,18,21–23,27 suggested that incretin drugs have the effect of improving the cognition of diabetes patients, and the results of two trials 20,26 were negative. Three trials suggested that the blood glucose of the incretin group was significantly lower than that of the control group 17,20,23 , and four trials suggested that there was no significant difference between the two groups 18,21,26,27 . In terms of hypoglycemic events, all results suggested that the risk of hypoglycemia in the incretin group was significantly reduced.…”

Section: Discussionmentioning

confidence: 90%

“…These neurodegenerative diseases are closely related to impaired glucose metabolism in diabetes. Among the eight trials included in the present meta-analysis, the results of six trials 17,18,[21][22][23]27 suggested that incretin drugs have the effect of improving the cognition of diabetes patients, and the results of two trials 20,26 were negative. Three trials suggested that the blood glucose of the incretin group was significantly lower than that of the control group 17,20,23 , and four trials suggested that there was no significant difference between the two groups 18,21,26,27 .…”

Section: ⊕ ⊕ ⊝ Moderatementioning

confidence: 88%

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Cognitive protection of incretin‐based therapies in patients with type 2 diabetes mellitus: A systematic review and meta‐analysis based on clinical studies

Chai

Liu

et al. 2023

J of Diabetes Invest

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Aims/introduction Cognitive dysfunction, including mild cognitive impairment and dementia, is increasingly recognized as an important complication of type 2 diabetes mellitus. The aims of the preset study was to investigate the cognitive protection of incretin‐based therapies, including glucagon‐like peptide‐1 receptor agonists and dipeptidyl peptidase‐4 inhibitors, in patients with type 2 diabetes mellitus. Materials and Methods PubMed, EMBASE, Cochrane library, Web of Science and PsycINFO were searched from the inception through 17 January 2023 for randomized controlled trials and cohort studies on the association between incretin‐based therapies and cognitive function. A total of 15 studies were finally included in our systematic review, and eight of which were incorporated into our meta‐analysis. Results Pooled results showed that the Mini‐Mental State Examination score in incretin‐based therapy groups was increased by 1.20 compared with the control group (weighted mean difference 1.20, 95% confidence interval 0.39–2.01). The results of eight studies assessed by the Newcastle Ottawa Quality Assessment Scale and the Cochrane Collaboration's tool, and the quality of the eight studies were at a relatively high level. Egger's regression did not show significant publication bias. Conclusions Current evidence shows that incretin‐based therapies might be more effective, when compared with the other hypoglycemic drugs, for cognitive improvement in patients with type 2 diabetes mellitus.

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Section: Discussionmentioning

confidence: 90%

Section: ⊕ ⊕ ⊝ Moderatementioning

confidence: 88%

Cognitive protection of incretin‐based therapies in patients with type 2 diabetes mellitus: A systematic review and meta‐analysis based on clinical studies

Chai

Liu

et al. 2023

J of Diabetes Invest

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“…During a follow-up of 6 months, sitagliptin increased MMSE scores in patients with AD compared to metformin treatment [ 36 ]. In addition, concomitant administration of vildagliptin with conventional antidiabetic treatment also improved cognitive function by targeting copying subdomain in older diabetic patients [ 40 ]. This improving effect on cognition might come from an increase of brain GLP-1 levels.…”

Section: Discussionmentioning

confidence: 99%

“…The current meta-analysis also revealed that DPP-4i had a significant effect on improving IADL scores. Although IADL is mainly an evaluation tool of daily living ability, this tool is also suggested to reflect cognitive function indirectly [ 36 , 40 ]. Due to the limited studies identified, a solid conclusion could not be drawn regarding the impact of DPP-4i on other comprehensive geriatric assessments, including BADL, CES-D, GDS, and MNA.…”

Section: Discussionmentioning

confidence: 99%

Dipeptidyl peptidase-4 inhibitors alleviate cognitive dysfunction in type 2 diabetes mellitus

Meng,

Yan,

Zhang

et al. 2023

Lipids Health Dis

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Background Patients with type 2 diabetes mellitus (T2DM) are commonly at high risk for developing cognitive dysfunction. Antidiabetic agents might be repurposed for targeting cognitive dysfunction in addition to modulation on glucose homeostasis. This study aimed to evaluate the impact of dipeptidyl peptidase-4 inhibitors (DPP-4i) on cognitive function in T2DM. Methods PubMed, Embase, Cochrane Library and Web of Science were systematically searched from inception to September 30, 2023. Weighted mean differences were calculated using the Mantel-Haenszel (M-H) fixed or random effects model based on the degree of heterogeneity among studies. Heterogeneity was evaluated using a Chi-squared test and quantified with Higgins I2. Sensitivity analysis was performed with the leave-one-out method, and publication bias was evaluated according to Begg’s and Egger’s tests. Results Six clinical trials involving 5,178 participants were included in the pooled analysis. Administration of DPP-4i generally correlated with an increase of Mini-Mental State Examination (MMSE) scores (1.09, 95% CI: 0.22 to 1.96). DPP-4i alleviated cognitive impairment in the copying skill subdomain of MMSE (0.26, 95% CI: 0.12 to 0.40). Treatment with DPP-4i also resulted in an increase of Instrumental Activities of Daily Living (IADL) scores (0.82, 95% CI: 0.30 to 1.34). However, DPP-4i produced no significant effects on Barthel Activities of Daily Living (BADL) scores (0.37, 95% CI: -1.26 to 1.99) or other test scores. Conclusions DPP-4i treatment favourably improved cognitive function in patients with T2DM. Further trials with larger samples should be performed to confirm these estimates and investigate the association of different DPP-4i with cognitive function among diabetic patients. Trial registration in PROSPERO CRD42023430873.

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“…Concerning sitagliptin, patients receiving sitagliptin had significantly increased MMSE scores compared to baseline [ 39 ]. Another study observed that vildagliptin therapy can improve some areas of cognitive function [ 40 ].…”

Section: Reviewmentioning

confidence: 99%

Anti-diabetics and the Prevention of Dementia: A Systematic Review

Slouha,

Ibrahim,

Rezazadah

et al. 2023

Cureus

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Type 2 diabetes mellitus (T2DM) is a worldwide epidemic that is only increasing as the years progress, and as of 2019, affecting over 37 million. T2DM is a chronic condition caused by reduced insulin secretion and increased insulin resistance. Due to insulin not operating at optimal conditions, blood glucose rises and remains high, thus disturbing metabolic hemostasis. Many complications can arise from T2DM, such as coronary vascular disease, kidney damage, eye damage, and, quite significantly, dementia. It is theorized that dementia from T2DM stems from the fact that the brain is susceptible to hyperglycemic conditions, which are promoted by the increase in insulin resistance of target cells in the central nervous system. This directly affects cognitive processes and memory, which correlates to decreased temporal and front lobes volume. The risk of diabetic complications can be minimized with therapeutic interventions such as oral-antidiabetic (OAD) agents and insulin. Several OADs are on the market, but the first-line agent is metformin, a biguanide that decreases glucose production and increases insulin sensitivity. This paper aims to determine if currently prescribed OADs can help slow cognitive decline and reduce the risk and incidence of dementia as a complication of T2DM. Studies found that, for the most part, all OADs except sulfonylureas (SU) significantly slowed the decline of cognitive function and reduced the risk and incidence of dementia. SU’s were shown to increase the risk of dementia in most studies. Of all the OADs, thiazolidinediones may be the most beneficial drug class for reducing the risk of dementia in T2DM patients. Future research should focus on whether early intervention with specific classes of OADs can not only improve glycemic control, leading to decreased hyperglycemia but also prevent the build-up of damaged brain tissue and help to reduce the risk and incidence of dementia in patients with T2DM.

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Cognitive and metabolic outcomes of vildagliptin addition to the therapy in patients with type 2 diabetes mellitus: 26 week follow-up study

Cited by 21 publications

References 35 publications

Cognitive protection of incretin‐based therapies in patients with type 2 diabetes mellitus: A systematic review and meta‐analysis based on clinical studies

Cognitive protection of incretin‐based therapies in patients with type 2 diabetes mellitus: A systematic review and meta‐analysis based on clinical studies

Dipeptidyl peptidase-4 inhibitors alleviate cognitive dysfunction in type 2 diabetes mellitus

Anti-diabetics and the Prevention of Dementia: A Systematic Review

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