Open Medicine,
Journal Year:
2025,
Volume and Issue:
20(1)
Published: Jan. 1, 2025
Diabetes-related
cognitive
impairment
is
increasingly
recognized
as
a
significant
complication,
profoundly
impacting
patients'
quality
of
life.
This
review
aims
to
examine
the
pathophysiological
mechanisms,
clinical
manifestations,
risk
factors,
assessment
and
diagnosis,
management
strategies,
future
research
directions
in
diabetes.
A
comprehensive
literature
search
was
conducted
using
PubMed,
Medline,
other
medical
databases
identify,
review,
evaluate
published
articles
on
The
focused
studies
examining
pathophysiology,
presentations,
diagnostic
approaches,
strategies.
current
revealed
that
chronic
hyperglycemia,
insulin
resistance,
vascular
factors
are
major
contributing
deficits
Clinical
manifestations
include
impairments
attention,
memory,
executive
function,
visuospatial
abilities,
language.
Risk
encompass
disease
duration,
glycemic
control,
presence
complications,
age,
education
level,
comorbidities.
Assessment
tools
screening
instruments,
neuropsychological
testing,
neuroimaging
techniques.
Management
strategies
involve
control
optimization,
lifestyle
modifications,
training,
pharmacological
interventions.
highlights
prevalence
impact
diabetes,
resulting
from
complex
metabolic
disturbances.
Early
detection
multifaceted
interventions
crucial
for
preserving
function
improving
patient
outcomes.
Future
should
focus
neuroprotective
biomarker
identification,
personalized
approaches.
Collaborative
efforts
between
clinicians
researchers
essential
effectively
address
this
growing
healthcare
challenge
enhance
life
individuals
with
diabetes-related
impairment.
International Journal of Molecular Sciences,
Journal Year:
2023,
Volume and Issue:
24(22), P. 16480 - 16480
Published: Nov. 18, 2023
The
association
of
diabetes
with
cognitive
dysfunction
has
at
least
60
years
history,
which
started
the
observation
that
children
type
1
mellitus
(T1D),
who
had
recurrent
episodes
hypoglycemia
and
consequently
low
glucose
supply
to
brain,
showed
a
deficit
capacity.
Later,
growing
incidence
2
(T2D)
dementia
in
aged
populations
revealed
their
high
association,
reduced
neuronal
also
been
considered
as
key
mechanism,
despite
hyperglycemia.
Here,
we
discuss
role
functioning/preservation,
how
peripheral
blood
accesses
intracellular
compartment,
including
exquisite
flux
across
blood–brain
barrier
(BBB)
complex
network
transporters,
dementia-related
areas
such
hippocampus.
In
addition,
insulin
resistance-induced
abnormalities
hippocampus
obese/T2D
patients,
inflammatory
stress,
oxidative
mitochondrial
increased
generation
advanced
glycated
end
products
BBB
dysfunction,
well
dementia/Alzheimer’s
disease,
are
addressed.
Finally,
these
accompained
by
reduction
expression
translocation
capacity
insulin-sensitive
transporter
GLUT4
hippocampal
neurons,
leads
neurocytoglycopenia
eventually
dysfunction.
This
knowledge
should
further
encourage
investigations
into
beneficial
effects
promising
therapeutic
approaches
could
improve
central
sensitivity
expression,
fight
diabetes-related
dysfunctions.
Biomedicines,
Journal Year:
2024,
Volume and Issue:
12(10), P. 2387 - 2387
Published: Oct. 18, 2024
Within
the
central
nervous
system,
synaptic
plasticity,
fundamental
to
processes
like
learning
and
memory,
is
largely
driven
by
activity-dependent
changes
in
strength.
This
plasticity
often
manifests
as
long-term
potentiation
(LTP)
depression
(LTD),
which
are
bidirectional
modulations
of
efficacy.
Strong
epidemiological
experimental
evidence
show
that
heart-brain
axis
could
be
severely
compromised
both
neurological
cardiovascular
disorders.
Particularly,
disorders,
such
heart
failure,
hypertension,
obesity,
diabetes
insulin
resistance,
arrhythmias,
may
lead
cognitive
impairment,
a
condition
known
cardiogenic
dementia.
Herein,
we
review
available
knowledge
on
molecular
mechanisms
dementia
arise
describe
how
LTP
and/or
LTD
induction
maintenance
CA1
region
hippocampus
metabolic
syndrome,
arrhythmias.
We
also
discuss
emerging
endothelial
dysfunction
contribute
directly
altering
hippocampal
impairing
synaptically
induced
activation
nitric
oxide
synthase.
A
better
understanding
CV
disorders
impact
proper
function
synapses
will
shed
novel
light
underpinnings
dementia,
thereby
providing
new
perspective
for
more
specific
pharmacological
treatments.
Cell Communication and Signaling,
Journal Year:
2025,
Volume and Issue:
23(1)
Published: Jan. 6, 2025
Cognitive
impairment
is
a
significant
complication
of
type
2
diabetes
mellitus
(T2DM).
However,
the
mechanisms
underlying
development
cognitive
dysfunction
in
individuals
with
T2DM
remain
elusive.
Herein,
we
discussed
role
Bmal1,
core
circadian
rhythm-regulating
gene,
process
T2DM-associated
dysfunction.
We
identified
marked
decrease
BMAL1
levels
hippocampus
db/db
mice,
followed
by
gain-
and
loss-of-function
studies
to
explore
impact
on
function.
Our
findings
indicated
that
downregulation
led
deficits,
characterized
tau
hyperphosphorylation
accumulated
amyloid
plaque.
Conversely,
overexpression
mitigated
these
Alzheimer-like
pathologies.
Further
investigation
revealed
directly
activated
transcription
Areg,
thereby
activating
PI3K/Akt/GSK-3β
pathway
ameliorating
Moreover,
effects
were
attenuated
LY294002,
PI3K
inhibitor.
Collectively,
results
underscore
impairment,
proposing
novel
intervention
strategy
for
exposed
risk
factors
T2DM.
Recent
research
has
shown
that
type
2
diabetes
mellitus
(T2DM)
increased
the
burden
of
Alzheimer's
disease
(AD)
in
US
aging
population.
However,
trends
mortality
from
this
comorbidity
among
adults
aged
≥
65
years
have
not
been
investigated.
This
study
examined
and
disparities
AD-related
older
with
T2DM
1999
to
2019.
Data
CDC
WONDER
database
were
analysed
assess
patients
between
Age-adjusted
rates
(AAMRs)
per
100,000
people
annual
percent
change
(APC)
calculated
stratified
by
year,
sex,
race/ethnicity,
age,
urbanisation
geographical
region.
From
2019,
there
71,550
deaths
AD
65.
AAMRs
rose
4.12
11.65
sharpest
increase
2014
2017
(APC:
10.81;
95%
CI:
-3.20
13.43).
Women
had
slightly
higher
than
men,
increasing
4.71
11.61
2019
for
women,
4.08
11.70
men.
Hispanic
individuals
saw
highest
AAMR
(11.15),
followed
non-Hispanic
Black
(9.30)
White
populations
(7.92).
West
(10.91)
Midwest
(9.62),
while
Northeast
(4.70)
lowest.
Nonmetropolitan
areas
consistently
(10.74)
large
metropolitan
(6.68)
small/medium
(9.25).
States
top
90th
percentile
T2DM-AD
included
California,
South
Dakota
Kentucky,
where
approximately
eight
times
states
lowest
10th
percentile.
reveals
a
significant
rise
comorbidity-related
adults,
especially
Hispanics,
women
rural
residents.
These
findings
underscore
need
targeted
interventions
reduce
vulnerable
populations.
medRxiv (Cold Spring Harbor Laboratory),
Journal Year:
2025,
Volume and Issue:
unknown
Published: Feb. 7, 2025
Abstract
Objectives
Deuterium
(
2
H)
Metabolic
Imaging
(DMI)
is
an
emerging
magnetic
resonance
technique
to
non-invasively
map
human
brain
glucose
(Glc)
uptake
and
downstream
metabolism
following
oral
or
intravenous
administration
of
H-labeled
Glc.
The
achievable
spatial
resolution
limited
due
inherently
low
sensitivity
DMI.
This
hinders
potential
clinical
translation.
purpose
this
study
was
improve
the
signal-to-noise
ratio
(SNR)
3D
DMI
via
a
balanced
steady
state
free
precession
(bSSFP)
acquisition
scheme
combined
with
fast
non-Cartesian
spatial-spectral
sampling
enable
high
dynamic
imaging
neural
Glc
glutamate+glutamine
(Glx)
synthesis
at
7T.
Materials
Methods
Six
healthy
volunteers
(2f/4m)
were
scanned
after
0.8
g/kg
[6,6’]-
H-Glc
using
novel
density-weighted
bSSFP
concentric
ring
trajectory
(CRT)
k-space
Time-resolved
whole
datasets
acquired
for
approximately
80
min
(7
per
dataset)
0.75ml
0.36ml
isotropic
results
compared
conventional
spoiled
Free
Induction
Decay
(FID)
H-MRSI
CRT
readout
matched
nominal
resolution.
Dynamic
measurements
accompanied
by
simultaneous
systemic
interstitial
tissue
continuous
monitoring
(CGM)
sensor
(on
upper
arm).
correlation
between
levels
analyzed
linear
mixed
models.
Results
bSSFP-CRT
approach
achieved
SNRs
that
up
3-fold
higher
than
FID-CRT
H-MRSI.
enabled
2-fold
Seventy
minutes
tracer
comparable
H-Glc,
H-Glx
H-water
concentrations
detected
both
schemes
both,
regular
resolutions
(0.75ml
0.36
ml
isotropic).
mean
Areas
Under
Curve
(AUC)
fluid
obtained
509±65
mM·min.
3.4
times
AUC
149±43
mM·min
models
fitted
assess
relationship
CGM
measures
yielded
statistically
significant
slope
estimates
in
GM
(β
1
=
0.47,
p
0.01)
WM
0.36,
0.03).
Conclusion
In
we
successfully
implemented
whole-brain
A
SNR
increase
allowed
us
double
Systemic
measurements,
DMI,
demonstrate
applications.
could
help
our
understanding
linking
it
time-resolved
peripheral
levels.
Importantly,
these
are
conducted
minimally
invasive
physiological
manner.
Scientific Reports,
Journal Year:
2025,
Volume and Issue:
15(1)
Published: Feb. 18, 2025
The
estimated
glucose
disposal
rate
(eGDR)
serves
as
a
novel
indicator
of
insulin
resistance,
which
has
been
shown
to
correlate
with
cardiovascular
disease
risk;
however,
its
relationship
cognitive
function
remains
unclear.This
article
describes
cross-sectional
study
design
based
on
data
from
the
2011–2014
National
Health
and
Nutrition
Examination
Survey
(NHANES).
Weighted
logistic
regression
restricted
cubic
spline
were
employed
examine
between
eGDR
ability.The
subjects
divided
into
two
categories:
normal
group
decline
(CFD)
group,
their
scores.
There
significant
differences
in
levels
groups(P
=
0.001).After
adjusting
for
relevant
covariates,
notable
found
when
was
expressed
both
continuous
categorical
forms
(P
<
0.05).
stability
these
findings
further
confirmed
through
sensitivity
analyses.This
difference
persisted
subgroups,
including
women,
individuals
education
beyond
high
school,
moderate
drinkers,
those
who
had
not
diagnosed
stroke
A
revealed
non-linear
an
inflection
point
(P-for-non-linear
0.05,
P-overall
0.001).
This
contributes
understanding
performance
by
identifying
potential
association.
Frontiers in Clinical Diabetes and Healthcare,
Journal Year:
2025,
Volume and Issue:
6
Published: Feb. 24, 2025
Diabetes
is
increasingly
recognized
as
a
condition
with
far-reaching
implications,
including
its
impact
on
cognitive
health
(1).
Early
observations
of
the
relationship
between
diabetes
and
impairment
date
back
over
century,
initially
based
simple
neuropsychological
assessments
comparing
individuals
without
diabetes.
Since
then,
large-scale
epidemiological
studies,
advanced
imaging
technologies,
neuropathological
investigations
have
solidified
this
association,
revealing
complex
interplay
metabolic
dysregulation
decline
(2,3).
mis
en
forme
:
Anglais
(Royaume-Uni)
Code
de
champ
modifié
(Royaume-Uni)Today,
it
well-established
that
type
2
face
1.6-fold
greater
risk
developing
dementia
compared
to
their
non-diabetic
peers.
Estimates
suggest
affects
20%
70%
people
diabetes,
depending
study
population
examined
(4).
Beyond
daily
living,
in
associated
higher
cardiovascular
events
mortality
Today,
(5).
The
disorders
shaped
by
multiple
interacting
factors,
among
which
socioeconomic
status
plays
crucial
role.
Education
level,
key
determinant
status,
has
been
widely
studied
shown
influence
Individuals
education
tend
lower
risk,
while
those
are
more
susceptible
lifestyle-related
diseases
such
hypertension,
obesity,
these
conditions
also
decline,
from
backgrounds
may
experience
severe
rapid
deterioration
functions
when
living
(6).
This
interconnected
suggests
disparities
not
only
increase
but
contribute
an
accelerated
through
prevalence
other
diseases.Of
note,
recent
COVID-19
pandemic
demonstrated
infected
patients
develop
levels
anxiety
depression,
well
increased
decline.
Given
at
infections,
can
be
hypothesized
infection
directly
or
indirectly
worsen
amplify
diabetic
(7).
However,
precise
remains
fully
established..
For
elderly
individuals,
particularly
coexisting
dementia,
managing
effectively
becomes
challenging.
growing
global
projections
pointing
even
steeper
rise
coming
decades,
diabetes-related
emerging
critical
public
challenge.
These
diminish
quality
life
for
millions
worldwide
impose
substantial
economic
burdens
healthcare
systems
both
direct
costs,
treatments,
indirect
like
lost
productivity
caregiving
expenses.Cognitive
now
acknowledged
significant
complication
It
encompasses
spectrum
disorders,
mild
profoundly
affect
individuals'
memory,
attention,
decision-making
abilities.
impairments
complicate
everyday
activities,
self-management
creating
feedback
loop
worsening
glycemic
control
(8).
Patients
dysfunction
often
behavioral
psychological
challenges
further
impede
ability
follow
medical
advice,
adhere
treatment
regimens,
maintain
consistent
blood
glucose
monitoring.
difficulties
lead
reduced
adherence,
less
frequent
monitoring,
variability.
cascading
effects
include
recurrent
episodes
hypo-and
hyperglycemia,
exacerbate
selfmanagement
(9).
vicious
cycle
compounded
inherently
demanding
nature
management.
Decision-making
about
insulin
dosing,
meal
planning,
physical
activity,
medication
adherence
complex,
requiring
effort
throughout
day.
impaired
function,
demands
prove
overwhelming,
increasing
complications
diminishing
(10).Research
uncovered
several
factors
contributing
dual
burden
impairment.
poor
control,
hypoglycemia,
age,
detrimental
social
isolation.
Each
exacerbates
faced
complicates
Despite
issues,
awareness
understanding
professionals
remain
inadequate.
Many
report
feeling
unsupported
misunderstood
attempting
address
challenges,
emphasizing
urgent
need
enhanced
specialized
training
providers
(3).Adding
complexity,
develops
insidiously,
early
subtle
signs
manifesting
during
middle
age
or,
some
cases,
before
40
symptoms
frequently
overlooked
attributed
causes,
delaying
diagnosis
intervention.
highlights
importance
implementing
proactive
screening
detection
strategies,
could
significantly
mitigate
progression
improve
patient
outcomes.
despite
recognition
issue,
integration
into
management
guidelines
relatively
advancement.
While
represents
positive
step
forward,
application
routine
clinical
practice
inconsistent
fragmented.
To
bridge
gap,
efforts
needed
standardize
approaches,
incorporate
care,
ensure
teams
equipped
tools
knowledge
necessary
effectively.
will
require
improved
commitment
reshaping
care
models
better
serve
burden.Despite
awareness,
gaps
Current
practices
lack
clear
consensus
most
effective,
how
should
performed,
what
thresholds
prompt
American
Association
(ADA)
recommends
annual
aged
65
older,
no
specific
guidance
exists
younger
adults,
evidence
occur
(11).While
(11).Emerging
therapies
offer
potential
hope.
Recently,
FDA
approved
two
anti-amyloid
monoclonal
antibodies
Alzheimer's
disease.
treatments
represent
breakthroughare
considered
promising
development,
role
populations
unclear.
Similarly,
GLP-1
receptor
agonists
(GLP-1RAs),
used
management,
neuroprotective
preclinical
studies
neurodegenerative
(12,13).
preventing
mitigating
yet
determined.
In
addition,
use
sodium-glucose
cotransporters-2
inhibitors,
another
class
novel
anti-diabetic
therapeutic
agents,
deficits,
although
exact
mechanisms
involved
still
elucicated
(14).
.
Most
existing
expert
opinion
rather
than
robust
data,
underscoring
comprehensive
research.
Longitudinal
larger
cohorts
extended
follow-up
periods
essential
establish
evidence-based
practices.
Technological
advances,
continuous
monitoring
(CGM),
solutions
improving
CGMs
enable
real-time
tracking
levels,
providing
insights
variability
(15,16).
accuracy
limited
extreme
research
optimize
impairments.To
impairment,
collaborative,
multidisciplinary
approach
just
beneficial,
-it
essential.
involve
diverse
team
professionals,
endocrinologists,
specialists,
primary
physicians,
educators,
dietitians,
therapists.
By
pooling
expertise,
create
model
optimizes
resources,
customizes
meet
unique
needs
each
individual,
ensures
seamless
pharmacological
non-pharmacological
strategies.In
addition
provided
teams,
professional
societies
hold
pivotal
catalyzing
systemic
change.
organizations
spearhead
broad-based
educational
initiatives
aimed
providers,
focusing
raising
intersection
disorders.
Such
development
targeted,
patient-centered
materials
simplify
information,
making
accessible
actionable
families
affected
conditions.
Moreover,
fostering
stronger
collaboration
various
specialties
disciplines
addressing
multifaceted
posed
burden.
Increased
investment
initiatives,
terms
funding
strategic
enhance
manage
overlapping
impacts
Through
concerted
efforts,
system
move
toward
holistic
approach,
ultimately
outcomes
affected.The
link
crisis.
creates
self-perpetuating
undermines
patients'
Addressing
issue
requires
deepen
our
underlying
mechanisms,
tailored
strategies.
New
technologies
already
playing
support
older
adults
They
efficient
response
fluctuations
patient's
needs,
provide
caregivers
remote
capabilities
faster
intervention
crises,
assist
adjusting
updating
long-term
plans
patterns
observed
data
collected.
Furthermore,
help
evaluate
selfmanagementAs
continues
obesity
rates
rise,
diabetesrelated
set
dramatically.
calls
immediate
action
researchers,
policymakers
alike.
investing
advancing
research,
promoting
we
challenge
worldwide.
