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Medical News Today
4 days ago
- Health
- Medical News Today
GLP-1s may offer better dementia protection than metformin
There were about 589 million adults around the world living with diabetes in 2024, with 90% having type 2 diabetes. Past studies have shown that people who have type 2 diabetes are at a higher risk of developing dementia. A new study has found that when it comes to the neuroprotective abilities of diabetes medications, people taking GLP-1 agonists had a significantly lower cumulative risk of developing dementia, when compared to metformin International Diabetes Federation reports there were about 589 million adults around the world living with diabetes in 2024, with 90% of these having type 2 diabetes. Past studies show that people who have type 2 diabetes — a chronic condition where the body does not use its insulin properly — are at a higher risk of developing dementia. 'Type 2 diabetes is not only a metabolic disorder but also a major risk factor for dementia, particularly Alzheimer's disease and other nonvascular dementias,' Szu-Yuan Wu, MD, MPH, PhD, professor of radiation oncology and pharmacoepidemiology at Asia University, and director of the Big Data Center at Lo-Hsu Medical Foundation at Lotung Poh-Ai Hospital, both in Taiwan, told Medical News Today.'The risk of developing dementia is approximately 1.7 times higher in individuals with type 2 diabetes than in the general population. This imposes significant burdens on families and healthcare systems,' Wu is first and co-senior author of a new study recently published in the journal BMJ Open Diabetes Research & study found that when comparing the neuroprotective abilities of two diabetes medications — metformin and glucagon-like peptide-1 receptor agonists (GLP-1 agonists) — participants taking GLP-1 agonists had a significantly lower cumulative risk of developing dementia, when compared to metformin. Comparing GLP-1s, metformin head-to-headFor this study, researchers analyzed electronic health record data from the global health research network TriNetX. Scientists focused on data from more than 87,000 people with an average age of 58 who had type 2 diabetes and were prescribed either metformin or a GLP-1 agonist, to track any dementia development. 'Although metformin is widely accepted as the first-line therapy for type 2 diabetes, its effects on cognitive outcomes have been inconsistent,' Wu said. 'We aimed to investigate whether starting with a second-line agent like GLP-1 agonists might confer greater protective effects against dementia.'No previous real-world study has directly compared GLP-1 agonists and metformin head-to-head for dementia prevention,' he continued. 'If GLP-1 agonists show superior neuroprotective benefits, this could challenge the traditional treatment paradigm and support initiating therapy with GLP-1 agonists in selected patients.''GLP-1 agonists have demonstrated mechanisms that include reducing neuroinflammation, enhancing cerebral glucose metabolism, and improving synaptic plasticity,' Wu added. 'Given these benefits, it is imperative that we continue exploring their broader therapeutic potential beyond glucose lowering.'GLP-1s lower Alzheimer's risk by 12% compared to metforminAt the study's conclusion, Wu and his team found that study participants taking GLP-1 agonists had a significantly lower cumulative risk of developing dementia — namely, 10% — with an incidence of about 2.5%.By comparison, the dementia incidence rate for those taking metformin was almost 5%. 'This nearly twofold difference in dementia incidence is clinically significant,' Wu explained.'It suggests that initiating treatment with GLP-1 agonists may be more effective than metformin in reducing dementia risk among individuals with type 2 diabetes. Given the high prevalence of both diabetes and dementia in aging populations, this strategy may reduce long-term public health burdens, including healthcare costs, caregiver stress, and institutionalization needs.'– Szu-Yuan Wu, MD, MPH, PhDThe researcher team also discovered that study participants taking GLP-1 agonists had a 25% lower risk of developing non-vascular dementias and a 12% lower chance of developing Alzheimer's disease, compared to participants taking metformin. 'These subtype-specific findings reinforce the mechanistic rationale for GLP-1 agonists in neuroprotection,' Wu said. 'They are known to reduce amyloid-beta accumulation, suppress tau hyperphosphorylation, improve cerebrovascular integrity, and lower systemic inflammation.''These effects are not only theoretical; clinical trials of agents like liraglutide have shown cognitive improvements in patients with early Alzheimer's disease. Our results support that these biological actions may translate into meaningful risk reduction in real-world populations,' he detailed.A novel, effective way of lowering dementia risk?MNT had the opportunity to speak with Michael Snyder, MD, FACS, FASMBS, medical director of the Bariatric Surgery Center at Rose Medical Center, founder and director of the Denver Center for Bariatric Surgery Foundation, and in-house obesity specialist for FuturHealth, about this study. Snyder, who was not involved in the research, commented that these findings are quite significant as an introduction to a novel and seemingly extremely effective way of decreasing the risk of type 2 diabetes related dementia, specifically, Alzheimer's disease and nonvascular dementia. 'Early research has suggested that GLP-1 medications may offer powerful benefits for brain health,' he explained. 'Obesity, insulin resistance, and type 2 diabetes are all known to increase the risk of dementia, largely due to their role in driving inflammation, vascular damage, and other long-term stressors on the brain. By targeting these underlying issues, GLP-1s, which are already widely used to treat obesity and diabetes, may offer indirect protection against cognitive diseases,' Snyder pointed out.'In addition, emerging evidence shows that GLP-1s may have direct neurological effects, influencing memory, cognitive function, and neuroinflammation,' he continued. 'Although promising, long-term studies and clinical trials are needed to fully understand GLP-1s impact on the brain. With that said, GLP-1s could play a pivotal role in preventing or slowing neurodegenerative diseases, marking a major step forward in the future of brain health.'More research needed for definitive conclusionsMNT also spoke to Jennifer Cheng, DO, chief of endocrinology at Hackensack Meridian Jersey Shore University Medical Center in New Jersey, about this research. 'As an endocrinologist who treats type 2 diabetes on a regular basis, I found the study to be thought provoking and an interesting avenue of research,' Cheng, who likewise was not involved in the research, commented. 'The cognitive complications of diabetes can be significant and life debilitating. The protective effect for diabetes is promising and may help with treatment decisions in the future. It is an interesting method of research and can lead to further discoveries.' 'We are discovering new effects of the GLP-1 medications and it is interesting to see the possible protective effects. Patients with diabetes do have increased risk for neurological disorders including vascular issues and dementia. This is just an observational study so there can be no conclusions about the medications being the definitive cause of the decreased risk of Alzheimer's and/or dementia.'– Jennifer Cheng, DO'For research next steps, it would be interesting to see the new GLP-1 medications, and effects of the GLP-1s, studied to see if it is definitive,' Cheng added. 'We cannot conclude that based on an observational study that the GLP-1 was the primary agent to help prevent the cognitive complications of diabetes, but it does warrant further investigation, especially with new GLP-1 medications in development.'
Business Recorder
25-07-2025
- Health
- Business Recorder
Experts urge awareness, junk food tax to curb obesity, cut health costs
ISLAMABAD: Pakistan can significantly reduce national health expenditure by controlling obesity by creating awareness and taxing unhealthy junk foods including sugary drinks, health experts in a media talk revealed here on Thursday. Speaking at an event organised by Novo Nordisk Pakistan titled, 'Unordinary Partnerships to Shape a Healthier Tomorrow' that brought together healthcare professionals, policymakers, and leaders to address the crucial issue of serious chronic diseases, particularly obesity, which impacts millions across Pakistan. The event was also attended by the Ambassador of Denmark to Pakistan, Jakob Linulf, along with the senior management of Novo Nordisk Pakistan. Speaking at the occasion, Jakob Linulf, the Danish ambassador to Pakistan, emphasised on the importance of collaboration, in healthcare by Danish companies like Novo Nordisk operating in Pakistan. He said, 'Partnerships are essential in the fight against obesity. Together, we can foster a healthier society and defeat obesity. I am confident that this culture will continue to positively impact the people of Pakistan'. He said that tackling the issue of diabetes will help increase life expectancy by 10 years from 67 to 77 years, besides increasing productivity. The health experts said that in all the developed countries refined sugar was heavily taxed as it only damages human health with zero benefits, while in Pakistan the government was providing subsidies to the sugar industry. They said that only through creating awareness and controlling the mass use of sugar, the country can save up to $2.6 billion which is being used for the treatment of obesity-related diseases. They further said that obesity is a direct impact of sugary drinks which in Pakistan was responsible for 400,000 deaths annually, higher than smoking. Pakistan at present is ranking third globally on diabetes and top-ranked on account of spreading sugar-related health issues. They said that obesity and non-communicable diseases, especially diabetes and heart diseases are increasing at an alarming rate in Pakistan to deal with the situation, immediate policy measures including increasing taxes on sugary drinks to prevent further losses are inevitable. They said as per International Diabetes Federation, 'Pakistan has the 3rd highest burden of diabetes worldwide with 33 million people living with the disease. In addition, Pakistan is unfortunately the world number 1 country with fastest growth of diabetes over the last one decade. If no immediate policy measures are taken, the number of people living with diabetes will increase to 62 million in Pakistan by 2045.' The cost of diabetes management in 2021 had reached to $2.640 billion in Pakistan which has serious consequence on the economy. Increased consumption of sugary drinks is among the major contributors to rapid spread of diabetes. The research proved that increasing tax on sugary drinks is an evidence-based strategy to reduce their consumption, obesity and diabetes. Rashed Rafique Butt, general manager of Novo Nordisk Pakistan, shared the organisation 100-year legacy of embracing new ideas and different approaches to defeat serious chronic disease which is reflected in their new corporate brand platform - Unordinary Drives Change. He stated, 'Having pioneered scientific breakthroughs, and with over 25 years of obesity research, our GLP-1 treatment supports millions in achieving effective weight loss. Addressing obesity requires collaboration and concerted efforts with diverse network of organizations and stakeholders including government, associations, communities and NGOs—to overcome barriers and drive real change for a healthier future for all'. Highlighting the urgent need for action, Dr Javed Akram, president Pakistan Society of Internal Medicine, emphasised that obesity affects nearly 38 million people in Pakistan and is classified as a disease by the World Health Organization. He acknowledged the extensive impact of obesity on both individuals and the healthcare system. Dr AH Amir, president Pakistan Society of Obesity urged the stakeholders to prioritise countering obesity in the public health discussions, advocating for an inclusive approach that promotes prevention and management while combating the stigma around obesity through effective media campaigns. The event concluded with a unified call to action, encouraging attendees to raise awareness and build collaborative efforts to combat the obesity epidemic in Pakistan. Novo Nordisk Pakistan remains committed to dedicated to leading the way in defeating obesity where healthier, longer lives are not just a possibility for some, but a reality for many. Novo Nordisk Novo Nordisk is a leading global healthcare company founded in 1923 and headquartered in Denmark. Copyright Business Recorder, 2025
Medical News Today
21-07-2025
- Health
- Medical News Today
Exercising 150 minutes 1-2 times a week may lower death risk by 33%
Research has shown that physical exercise can help increase insulin sensitivity and help regulate blood sugar more effectively in people with diabetes.A new study found that people with diabetes who meet current physical activity recommendations through either regular physical activity or a 'weekend warrior' type of format have a reduced risk for both all-cause mortality and cardiovascular-related mortality, compared to people who do not also found that study participants who were insufficiently active still had a lower risk for all-cause and heart disease-related mortality than those who were completely inactive. According to the International Diabetes Federation, about one in every nine adults around the world is living with diabetes — a chronic condition where the body does not process blood sugar properly. Of that number, more than 95% of diabetes cases are type 2 diabetes, which is a condition a person develops, compared to type 1 diabetes where a person is born with the disease. People who have obesity, have certain conditions like high blood pressure, and who are not physically active are at a high risk of developing type 2 diabetes. People with either type of diabetes are at a high risk for health-related complications such as neuropathy, cognitive decline, foot issues, kidney damage, skin conditions, and heart disease. 'People with type 2 diabetes still face a significantly elevated risk of cardiovascular mortality, which is the leading cause of death among this high-risk population,' Zhiyuan Wu, PhD, postdoctoral research fellow in the Department of Nutrition at Harvard School of Public Health, told Medical News Today. 'While medication treatments are effective, lifestyle modifications — such as increasing and optimizing physical activity recommendations — are also essential for risk reduction.'Wu is the first author of a new study recently published in the journal Annals of Internal Medicine that has found people with diabetes who meet current physical activity recommendations through either regular physical activity or a 'weekend warrior' type of format have a reduced risk for both all-cause mortality and cardiovascular-related mortality, compared to people who do not also found that study participants who were insufficiently active still had a lower risk for all-cause and heart disease-related mortality than those who were inactive. Focusing on moderate-to-vigorous exerciseFor this study, researchers analyzed health data from more than 51,000 study participants with self-declared diabetes and an average age of about 60 from the National Health Interview Survey (NHIS). Study participants were broken into four categories based on their moderate-to-vigorous physical activity (MVPA):Regularly active with 150 minutes or more of exercise per week over three or more sessions. 'Weekend warriors' with 150 minutes or more of exercise per week completed in one or two active with less than 150 minutes per with reporting no MVPA during the week. The American Diabetes Association's (ADA) current recommendations are at least 150 minutes of MVPA per week. Examples of MVPA include jogging, brisk walking, dancing, hiking uphill, and playing basketball or football. 'Weekend warrior' vs. regular physical activityAt the study's conclusion, researchers found that 'weekend warriors' had a 21% lower all-cause mortality risk and 33% lower cardiovascular mortality risk when compared to inactive participants. Study participants who were regularly active had a 17% lower all-cause mortality risk and 19% lower risk of cardiovascular mortality, when compared to those who did not exercise regularly.'We found that 'weekend warriors' had similar reductions in all-cause and cardiovascular mortality as those who exercised more regularly, as long as they reached the recommended weekly MVPA amount,' Wu explained. 'This is important because many people struggle to meet current exercise guidelines that recommend activity spread over multiple days per week.''In fact, adherence to current guidelines is under 50% among this population,' he continued. 'Our findings suggest that a more flexible approach — like doing 150 minutes of exercise just on weekends — can still provide comparable health benefits and may be easier to stick with for people with busy schedules — demanding work schedules, family responsibilities, or limited access to safe and convenient exercise facilities nearby.' Insufficient physical activity still better than noneWu and his team also found that even participants who were insufficiently active still had a lower all-cause and cardiovascular mortality, when compared to inactive participants. 'Our findings show that any amount of physical activity is better than none,' Wu said. 'Even participants who didn't meet the recommended exercise goals still had a lower risk of death compared to those who were completely inactive.' 'This is an encouraging message for people with type 2 diabetes: you don't have to be perfect to benefit,' he continued. 'Simply starting to move — even in small amounts — can make a meaningful difference in your long-term health.''The next step is to validate these findings using objective measures of physical activity, such as wearable devices or digital health apps, instead of relying on self-reported questionnaires,' Wu added. 'And look into the biological mechanisms, such as host metabolites and proteins, to help explain the similar benefits observed for regular active and 'weekend warriors' patterns.'Physical activity important for people with diabetesMNT spoke with Cheng-Han Chen, MD, a board certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA, about this study. 'This prospective cohort study found that exercising at least 150 minutes per week over one to two sessions was associated with a 33% lower risk of cardiovascular mortality in patients with diabetes,' Chen commented. 'These results highlight the importance of incorporating physical activity into one's lifestyle in order to reduce the risk of cardiovascular disease, especially in people with other known risk factors such as diabetes.'Diabetes and heart health'Cardiovascular disease is currently the leading cause of death in people with diabetes. It is imperative that we tackle all modifiable risk factors in order to better control the terrible burden that this condition has on our society. We should make all public health efforts to promote regular physical activity in our population.' — Cheng-Han Chen, MD1-2 sessions of exercise may be enough to see benefitsMNT also talked to Aaron Feingold, MD, chair of cardiology at JFK University Medical Center in New Jersey, about this research. He commented that his first reaction was one of cautious optimism and practical excitement. 'The finding that weekend warriors — those who concentrate their 150+ minutes of moderate-to-vigorous physical activity into just 1-2 sessions per week — achieved nearly equivalent mortality benefits to those exercising regularly throughout the week is genuinely practice-changing. This challenges the conventional wisdom that exercise must be spread evenly across the week to be maximally beneficial.'— Aaron Feingold, MD'For my patients with diabetes who struggle with time constraints, work schedules, or other barriers to frequent exercise, this provides compelling evidence that concentrated weekend activity can still deliver substantial cardiovascular protection, he continued. 'Many of my patients express that they simply cannot find time for regular daily exercise due to work, family obligations, or other commitments. By demonstrating that flexible, concentrated exercise patterns can provide similar mortality benefits, we're expanding the toolkit of evidence-based interventions that can realistically fit into patients' lives.' 'This research is crucial because cardiovascular disease remains the leading cause of death in patients with diabetes, accounting for approximately 65% of deaths in this population,' Feingold added. 'What makes this study particularly valuable is that it addresses real-world barriers to exercise adherence. This is especially important given that lifestyle modifications like physical activity are often more accessible and have fewer side effects than pharmacological interventions.'
IOL News
08-07-2025
- Health
- IOL News
Malnutrition, not sugar: the surprising truth about type 5 diabetes
Whether it's rooted in excess or scarcity, diabetes is a growing global crisis. Image: Polina Tankilevitch /pexels Type 5 Diabetes is real - and it's tied to malnutrition, not sugar. Here's what you need to know: For years, diabetes has been framed as a lifestyle condition linked to poor diet and weight gain, but that's not the full story. A new type of diabetes, now officially recognised by the International Diabetes Federation (IDF) as Type 5 diabetes, is turning that belief on its head. And it's hitting the world's poorest communities hardest. On April 9, Type 5 diabetes was formally added to the global classification system, the first new entry of its kind in decades. What makes this type different? It's caused not by overnutrition, but by chronic undernutrition and the people most at risk aren't those with excess fat, but those without enough food during critical early stages of development. 'Malnutrition‑related diabetes has historically been vastly under‑diagnosed and poorly understood,' said Dr Meredith Hawkins, endocrinologist at Albert Einstein College of Medicine and founding director of the Global Diabetes Institute (GDI), in an interview with Video Player is loading. Play Video Play Unmute Current Time 0:00 / Duration -:- Loaded : 0% Stream Type LIVE Seek to live, currently behind live LIVE Remaining Time - 0:00 This is a modal window. Beginning of dialog window. Escape will cancel and close the window. Text Color White Black Red Green Blue Yellow Magenta Cyan Transparency Opaque Semi-Transparent Background Color Black White Red Green Blue Yellow Magenta Cyan Transparency Opaque Semi-Transparent Transparent Window Color Black White Red Green Blue Yellow Magenta Cyan Transparency Transparent Semi-Transparent Opaque Font Size 50% 75% 100% 125% 150% 175% 200% 300% 400% Text Edge Style None Raised Depressed Uniform Dropshadow Font Family Proportional Sans-Serif Monospace Sans-Serif Proportional Serif Monospace Serif Casual Script Small Caps Reset restore all settings to the default values Done Close Modal Dialog End of dialog window. Advertisement Next Stay Close ✕ Type 5 diabetes is caused by malnutrition during early development, not overeating common in lean people. Image: Lagos Food Bank Initiative/pexels What is Type 5 diabetes? Type 5 diabetes primarily affects people in Asia and Africa, especially lean adolescents and young adults who experienced poor nutrition during childhood. According to the IDF Diabetes Atlas (11th edition), about 20 to 25 million people are already living with this type a number that rivals HIV infection rates in the same regions. Unlike the familiar Type 2 diabetes, which is often linked to high-calorie diets and obesity, Type 5 develops when the pancreas fails to develop fully in childhood due to nutrient deficiencies particularly low protein intake during pregnancy or adolescence. An article cited in "The Conversation" explains that rodent models have shown a clear connection between a low-protein diet and underdeveloped pancreases, which translates to reduced insulin production capacity. Simply put: if your body never built enough insulin-producing cells as a child, you're at higher risk for developing diabetes later even if you stay lean and active. This newly recognised condition is more than a medical milestone it's a call to rethink global health narratives. Most public awareness campaigns around diabetes centre on obesity, sugar, and sedentary lifestyles, often overlooking the fact that millions of people face a very different risk one rooted in poverty and food insecurity. This also exposes the health gap in countries battling undernutrition and limited access to healthcare. Type 5 diabetes often goes undiagnosed or misdiagnosed, as it doesn't fit the typical profile healthcare workers are trained to look for. As Hawkins noted, expanding our understanding of diabetes types is not just about labels; it's about making sure the right people get the right treatment. Recognising Type 5 diabetes is just the beginning. Image: Nataliya Vaitkevich/pexels Types of diabetes Here's a simplified breakdown of the major types of diabetes to better understand where Type 5 fits in: Type 1 Diabetes: An autoimmune condition where the body attacks insulin-producing cells. Usually appears early in life. Not linked to diet or weight. Treated with lifelong insulin therapy Type 2 Diabetes: The most common type, often linked to obesity but not exclusively This can be reversed with diet, exercise, and medication (like Metformin) Ethnic background and genetics also play a role Managed through lifestyle changes, tablets or insulin Gestational Diabetes Temporary condition during pregnancy due to hormonal shifts. Increases the future risk of Type 2 diabetes. Treated with dietary changes, insulin or tablets. Type 5 Diabetes Caused by malnutrition during early development, not overeating. Common in lean people, especially in resource-poor countries. Requires a new clinical approach to diagnosis and treatment. Still under-recognised in mainstream health systems. Why nutritional equity is keyType 5 diabetes shines a spotlight on how early-life nutrition or the lack thereof can leave permanent damage. It also challenges the global focus on obesity as the face of diabetes, urging health systems to prioritise food security and maternal nutrition as long-term investments in public health. This is more than a medical discovery, it's a wake-up call. With nearly one in nine adults living with diabetes worldwide, and more than 250 million people undiagnosed (International Diabetes Federation, IDF), it's time to think of diabetes in a new light, one that looks at inequality, not just indulgence. Whether it's rooted in excess or scarcity, diabetes is a growing global crisis. Recognising Type 5 diabetes is just the beginning. Now, the challenge is making sure people in affected communities are seen, heard, and treated starting with redefining the narrative around who is at risk and why.
South China Morning Post
22-06-2025
- Health
- South China Morning Post
The unsung spleen may play a big role in fighting diabetes: Chinese scientists
Advances in the transplant of cells into the spleen could transform one of the body's 'expendable' organs into a hub for treating diabetes , two Chinese studies have found. Research published last month by scientists at Nanjing University and other institutes found that 'shielding' islet cells could improve their survival after being transplanted into the spleen to treat type 1 diabetes. They also found that the spleen – a more promising long-term survival site than the conventionally used liver – could be engineered into a transplant hub with the help of nanoparticles. 06:23 Can China claim the leadership mantle after the US quits the WHO and Paris Agreement? Can China claim the leadership mantle after the US quits the WHO and Paris Agreement? 'If the safety and effectiveness of the spleen as a host organ for islet transplantation are fully demonstrated through systematic clinical studies in the future, the spleen can be used as an ideal organ for islet transplantation,' said Dong Lei, professor and vice-dean of the Nanjing University school of life sciences, who contributed to both studies. An estimated 589 million adults worldwide have diabetes, with this number expected to rise to 853 million by 2050, according to the International Diabetes Federation. China has the highest number of adults with diabetes in the world, at more than 140 million people. Type 1 diabetes is a genetic autoimmune disorder characterised by the body's immune system attacking islet cells in the pancreas that make insulin, the hormone needed to store and convert blood sugar into energy. While symptoms of type 1 diabetes, which accounts for about 5 per cent of cases, can be managed using medication, such as insulin injections, there is no cure for the condition.
