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Could a Diabetes Medication Hold the Key to Alzheimer’s Treatment?

  • Writer: Jeffrey Galvin
    Jeffrey Galvin
  • Apr 9
  • 3 min read

Exploring the Latest Research on GLP-1 Agonists and Brain Health

In recent years, medications known as GLP-1 receptor agonists—originally developed to help manage type 2 diabetes, have shown exciting potential in areas far beyond blood sugar regulation. Many of our patients are already familiar with these medications through names like Ozempic, Trulicity, and Mounjaro. But what if one of these medications could help slow or even reverse cognitive decline?



That’s exactly the question posed by a compelling new paper titled: “All GLP-1 Agonists Should, Theoretically, Cure Alzheimer’s Dementia but Dulaglutide Might Be More Effective Than the Others” by Dr. Jeffrey Fessel, published in Brain Sciences (July 2024).


Read the full article here on PubMed Central: https://pmc.ncbi.nlm.nih.gov/articles/PMC11242057/


The Premise: Targeting All Brain Cell Types

Alzheimer’s disease is fundamentally a disease of brain cell dysfunction. The paper outlines that for any therapy to be truly effective, it must reach and support all major brain cells affected in Alzheimer’s, including:

  • Neurons

  • Oligodendrocytes (which help with myelin and nerve signaling)

  • Astrocytes (critical for glucose metabolism)

  • Microglia (inflammatory cells)

  • Endothelial cells and pericytes (vital to brain blood flow)


Here’s where it gets exciting: GLP-1 receptors are found on all of these cell types. That means drugs targeting these receptors have the potential to help every part of the brain affected by Alzheimer’s.


So Why Dulaglutide?

Among all the GLP-1 drugs currently on the market, dulaglutide (Trulicity) stands out in this paper for one critical reason: its ability to enter the brain.

  • Dulaglutide has the highest brain penetration of all GLP-1 agonists studied—about 62% of the drug crosses into the brain tissue.

  • By comparison, popular drugs like liraglutide (Victoza) or semaglutide (Ozempic) barely make it into the brain at all.


This higher penetration means dulaglutide might be better equipped to directly influence brain health and cognition.


A Promising Study with 8,828 Participants

The highlight of the paper is a large, randomized, placebo-controlled trial of 8,828 older adults with type 2 diabetes. Those who received dulaglutide:

  • Showed a 14% lower risk of cognitive decline over 5 years compared to placebo.

  • This was measured using standard cognitive tests (MoCA and DSST).

  • Importantly, participants had no dementia at baseline—meaning dulaglutide may have a role in prevention or early intervention.


While no drug can yet claim to “cure” Alzheimer’s, these results make dulaglutide a compelling candidate for future trials.


 The Good News

  • Mechanism-based: GLP-1 agonists address multiple pathways involved in Alzheimer’s, from inflammation to oxidative stress and synaptic repair.

  • Human data > animal data: This paper emphasizes findings in humans, making it more applicable to patient care.

  • Large sample size: The dulaglutide study was robust, long-term, and well-controlled.


The Limitations

  • Only one study with dulaglutide and cognition in humans exists so far. While encouraging, it’s not conclusive.

  • No direct Alzheimer's diagnosis: The trial studied cognitive decline in diabetics, not patients with diagnosed Alzheimer’s.

  • Other GLP-1 drugs may not help: Drugs like semaglutide and liraglutide have poor brain entry, which might explain why they’ve shown inconsistent or no benefit in smaller studies.

  • Cure is a strong word: The idea of a "cure" is theoretical. More research is needed to validate this in Alzheimer's patients.


Our Take

At Vitality, we always seek forward-thinking yet evidence-based strategies for longevity and brain health. While GLP-1 agonists like dulaglutide show promise, especially for those with diabetes or prediabetes, they are not yet approved for treating Alzheimer’s. However, we’re watching this space closely and when the next large trials emerge, we’ll be the first to evaluate them for your care plan.


If you're already taking a GLP-1 medication and are concerned about cognitive health, let’s talk. If you're curious whether you might be a candidate, we’re happy to walk you through your options.

 
 
 
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