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May 13, 2021  
WOUND NEWS: Feature Story

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  • Diabetes Medication May Work for Alzheimer's

    Diabetes Medication May Prove Effective for Alzheimer’s

    August 31, 2006

    By: Jean Johnson for Wound1

    The beauty of science is that we never know when the field is going to reveal a new variation on an old theme. Modern medicine knows a lot about the body and disease, but creative researchers that ask new questions and put together careful studies can discover results that open new avenues of thought, treatment, and ultimately healing.
    Take Action
    Caring for a loved one with Alzheimer’s? Here are 12 ways to boost success from the Alzheimer’s Foundation of America:

  • Educate yourself about the disease. Read books, attend workshops and consult with healthcare professionals.
  • Learn caregiving techniques. Key areas are communication skills, safety concerns, and managing behavioral challenges and activities of daily living.
  • Understand the experience of your loved one. Adjust your expectations. Be patient and kind.
  • Avoid caregiver burnout. Make time for yourself. Join caregiver support groups. Pursue interests beyond your caregiving role, such as exercise, hobbies, journaling and art.
  • Maintain your own physical and mental health. Exercise, respite and other activities can reduce stress. Seek medical help if there are signs of depression.
  • Discuss the situation with family and friends. Support systems are critical.
  • Do cognitive stimulation activities with your loved one. Listening to music, word puzzles and memory games can easily be done at home.
  • Foster communication with physicians. Be involved in your loved one's medical care. Ask questions about the progression of the disease, express concerns and discuss treatment options.
  • Take care of financial, legal and long-term care planning issues. Try to involve your loved one in decision-making, if they are still capable of providing input, and consider their wishes related to future care and end-of-life issues.
  • Smile. Kindness, humor and creativity are essential parts of caregiving. Hugs, hand massage and other gentle physical contact will help your loved one feel connected and loved.
  • Think positive. Focus on your loved one's remaining strengths and enjoy your relationship while you are still able to.
  • Reach out for care. Call the Alzheimer's Foundation of America at 866.AFA.8484 or
    visit them online for counseling, information and referrals to local resources nationwide.

  • In research coming out over the last 5-10 years, an increasing number of studies have detected relationships between diabetes and Alzheimer’s. That’s why this year’s International Conference on Alzheimer’s Disease (ICAD) in Madrid, Spain, highlighted new findings on how a drug called pioglitazone, which as been approved by the U.S. Food and Drug Administration (FDA) for diabetes, may help patients with mild to moderate Alzheimer’s without causing serious side effects.

    Alzheimer’s, the Grieving Disease

    Families of those with Alzheimer’s, which robs 4.5 million older Americans of their own mental faculties, who have heard the news are cautiously hopeful. As one Alzheimer patient – who was an Oregon physician until his health forced an early retirement and ultimately relocation to a locked down, assisted living residence – told MedTech1 recently in a frenetic, disturbed voice with his forehead furrowed heavily over deep blue eyes, “I can’t follow very well for too long. It’s like a mess.

    “My mind gets all mixed up. I lose track of things.” The tidy, fresh-shaven man with one bare foot showing beneath his khaki trousers would have stayed to visit further, he implied. But he glanced down to his bare wrist where he must have once sported a watch and said, “I’m pretty busy. I don’t have much time.” We nodded with understanding and pressed our lips together in a thin line, while he wandered off to the dining room in search of his other shoe and sock.

    We didn’t talk to the former physician about the new findings, of course, but if his mind was as facile as it must have been when he was in his prime, we imagine he would have found the research coming out of the University of Virginia (UVa) Health System and Case Western Reserve University in Charlottesville compelling and hopeful. At essence, explains David Geldmacher, M.D. and associate professor of neurology at UVa, the connection between the two diseases may be part of the mix that courses through the body.

    Off-label Uses for Drugs Can Lead to New Knowledge

    “We believe that the drug may reduce the body’s inflammatory reaction to one of the toxic components that builds up in Alzheimer’s called amyloid plaque,” Geldmacher said in a UVa press release.

    One of the issues here is what’s known as off-label use of a drug for conditions the FDA has not determined are acceptable. But instead of individual physicians seeing results on handfuls of patients in their private practices and then simply going out on the continuing education lecture circuit (while getting paid fees that can run to $100,000 annually from drug manufacturers), the work on pioglitazone is coming out of a university setting with the evidence-based results presented at the world’s largest international conference dedicated to Alzheimer’s research.

    That said, the trial was an academic-government-private partnership, and supported by both the National Institutes of Health and Takeda Pharmaceuticals North America, Inc., the company that manufacturers pioglitazone. Still, given the ties to the NIH and the academy, this research is presumably not tainted by short-term personal gain and the murky relationships between physicians and drug manufacturers that are increasingly being exposed in investigative news sources like the New York Times.

    The Study

    The placebo-controlled study tested 25 people who have mild to moderate Alzheimer’s. The trial assessed both the safety of pioglitazone and its ability to reduce the progression of Alzheimer’s and the disease’s effects on memory and everyday abilities. Since the number of participants in the study was so small, investigators remain guarded in their conclusions.

    They do say, however, that the findings are promising enough to carry out further studies on the drug with larger numbers of patients. Consequently Geldmacher’s team hopes to plan a nationwide study in the next few years that will follow the response 200-300 people to the diabetes drug.

    “We don’t know exactly how pioglitazone works in Alzheimer’s, but there are two possibilities,” Geldmacher said. “It could be that the drug reduces the body’s response to the amyloid protein found in Alzheimer’s. Or it could be that this drug helps brain cells function.”

    That said, Geldmacher did let his enthusiasm for the scientific breakthrough show. “The real advantage,” he noted, “is that it’s a completely novel approach to treating the disease.”

    Referring to plans for a larger study, Geldmacher added, “If it works, this treatment might allow people to better hold on to memory and brain function over a period of time, despite having Alzheimer’s. It could also complement other treatments and become part of a multi-pronged approach to Alzheimer’s treatment.”

    Currently there are five drugs approved by the FDA for the treatment of Alzheimer’s, but according to Geldmacher, pioglitazone is not related to any of them. Thus his optimism for the research and its potential for expanding the treatment options for Alzheimer’s patients.

    Last updated: 31-Aug-06


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