Sodium–glucose cotransporter 2 inhibition through henagliflozin ameliorates cognitive impairment in patients with type 2 diabetes

Abstract

Abstract Aims/Introduction To assess whether the sodium–glucose cotransporter 2 inhibitor, henagliflozin, improves cognitive impairment in patients with type 2 diabetes. Materials and Methods We carried out a prospective study on 290 patients with type 2 diabetes and cognitive impairment. Montreal Cognitive Assessment scores and plasma phosphorylated tau181 levels were used to assess cognition. The association between henagliflozin use and changes in cognition was examined using multivariable logistic regression analysis. Results Montreal Cognitive Assessment scores at enrollment and after 6 months were 21 (interquartile range [IQR]19–23) versus 22 (IQR 20–25; P 0.05) in the non‐sodium–glucose cotransporter 2 inhibitor group. Logistic regression analysis showed that henagliflozin treatment was associated with Montreal Cognitive Assessment score improvement independent of potential confounders (odds ratio [OR] 3.670, 95% confidence interval [CI] 2.224–6.056, P < 0.0001). Additionally, plasma phosphorylated tau181 levels significantly decreased at 6‐month follow up in all patients (OR 11.5, 95% CI 9.9–13.7 vs OR 10.1, 95% CI 7.8–12.9, P < 0.0001) and in the henagliflozin group (OR 11.5, 95% CI 10.3–13.0 vs OR 9.2, 95% CI 7.1–10.7, P < 0.0001), but not in the non‐sodium–glucose cotransporter 2 inhibitor group. Henagliflozin treatment was independently associated with decreased phosphorylated tau181 levels (OR 3.670, 95% CI 1.598–4.213, P < 0.0001). Conclusions Henagliflozin treatment was independently associated with improvements in Montreal Cognitive Assessment scores and plasma phosphorylated tau181 levels, indicating significant beneficial effects on cognitive impairment in patients with type 2 diabetes.

Keywords

• Cognitive impairment
• Henagliflozin
• Type 2 diabetes