The Effect of SGLT2 Inhibitors on Cognitive Functions and BDNF Levels in Patients With Type 2 Diabetes

Sponsor

Goztepe Training and Research Hospital (Other)

Overall Status

Terminated

CT.gov ID

NCT05341388

Collaborator

(none)

Enrollment

Location

Actual Duration (Months)

2.8

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

Cognitive impairment is a common complication in diabetes for various reasons. Although glycemic control improves cognitive impairment, different antidiabetic medications' effects on cognitive functions are still being investigated. Brain-derived neurotrophic factor (BDNF) is a neuroinflammatory marker and a member of the neurotrophin family with growth factor properties. BDNF levels have been shown to decrease in mild cognitive dysfunction or in late-onset Alzheimer's disease. Our aim is to examine the effect of SGLT2 inhibitor use on cognitive functions and BDNF levels.

Condition or Disease	Intervention/Treatment	Phase
Type2 Diabetes Cognitive Impairment	Diagnostic Test: MOCA cognitive evaluation test Diagnostic Test: BDNF levels Other: SF-36 test Diagnostic Test: Geriatric depression test

Detailed Description

Type 2 diabetes is a complex metabolic disorder that can cause serious damage to various organs. Impairment in cognitive functions is one of the common complications in patients with diabetes. Impairment in cognitive functions and significant dementia were found to be approximately 1.5 times more common in individuals with diabetes than individuals without diabetes. In particular, inadequate glycemic control, the frequency of hypoglycemia, vascular diseases, insulin resistance, inflammatory cytokines and oxidative stress stand out as possible causes. Brain-derived neurotrophic factor (BDNF) is a member of the neurotrophin family with growth factor properties. BDNF plays a critical role in cell differentiation, migration, and survivable synaptic plasticity of neurons. BDNF also has an important role in learning and memory processes through synapses in the hippocampus. BDNF levels have been shown to decrease in mild cognitive dysfunction or in late-onset Alzheimer's disease. In animal experiments, it has been observed that BDNF values increase with the use of metformin in Parkinson's disease. Similar results were obtained with vildagliptin, alogliptin, rosiglitazone, and exendin-4 in animal experiments.

The effects of drugs used in the treatment of diabetes on protecting or improving cognitive functions have been studied for a long time. Most of these studies are at the preclinical level. In previous studies with Glucagon-Like Peptide 1 (GLP-1) agonists and dipeptidyl peptidase 4 (DPP-4) inhibitors, there are data that both glycemia and incretins improve cognitive functions with their effects on brain structure. Similar positive results are seen for thiazolidinediones. While hyperglycemia control leads to positive results in insulin and sulfonylurea group drugs, the frequency of hypoglycemia can have a negative effect. There is not enough data on SGLT2 inhibitors.

Studies with SGLT2 inhibitors have shown a decrease in HbA1c values, weight loss, and a decrease in both systolic and diastolic blood pressure. Encouraging results have been obtained with SGLT2 inhibitors in both cardiac and renal outcomes, with heart failure in the foreground. As a result of these data, they are recommended as drugs that should be used in the foreground following metformin, especially in diabetic patients with cardiac and renal diseases. Animal studies with empagliflozin and canagliflozin show that both agents reduce cognitive impairment.

Our aim is to examine the effect of SGLT2 inhibitor use on cognitive functions and BDNF, one of the neuroinflammatory markers.

Study Design

Study Type:

Observational

Actual Enrollment :

25 participants

Observational Model:

Case-Control

Time Perspective:

Prospective

Official Title:

The Effect of SGLT2 Inhibitors on Cognitive Functions and a Neuroinflammatory Biomarker, Brain-Derived Neurotrophic Factor Levels in Patients With Type 2 Diabetes

Actual Study Start Date :

Mar 1, 2021

Actual Primary Completion Date :

Nov 30, 2021

Actual Study Completion Date :

Nov 30, 2021

Arms and Interventions

Arm	Intervention/Treatment
Patients with type 2 diabetes-SGLT2 inh patients with type 2 diabetes who were recently prescribed an SGLT2 inhibitor	Diagnostic Test: MOCA cognitive evaluation test Before starting their newly prescribed medication, we will apply MOCA and repeat it at the end of the trial. Diagnostic Test: BDNF levels Before starting their newly prescribed medication, we will apply MOCA and repeat it at the end of the trial. Other: SF-36 test Before starting their newly prescribed medication, we will apply MOCA and repeat it at the end of the trial. Diagnostic Test: Geriatric depression test Before starting their newly prescribed medication, we will apply MOCA and repeat it at the end of the trial.
Patients with type 2 diabetes-control patients with type 2 diabetes who were recently prescribed a pre-defined antidiabetic medication other than SGLT2 inhibitors	Diagnostic Test: MOCA cognitive evaluation test Before starting their newly prescribed medication, we will apply MOCA and repeat it at the end of the trial. Diagnostic Test: BDNF levels Before starting their newly prescribed medication, we will apply MOCA and repeat it at the end of the trial. Other: SF-36 test Before starting their newly prescribed medication, we will apply MOCA and repeat it at the end of the trial. Diagnostic Test: Geriatric depression test Before starting their newly prescribed medication, we will apply MOCA and repeat it at the end of the trial.

Arm

Intervention/Treatment

Patients with type 2 diabetes-SGLT2 inh

patients with type 2 diabetes who were recently prescribed an SGLT2 inhibitor

Diagnostic Test: MOCA cognitive evaluation test