Cited by 315Dementia and Cognitive Impairment ResearchAlzheimer's disease research and treatmentsDiabetes Management and Research

Type 2 diabetes mellitus and Alzheimer’s disease

Open access
Barbagallo, Mario·2014·World Journal of Diabetes

Abstract

Epidemiological and biological evidences support a link between type 2 diabetes mellitus (DM2) and Alzheimer's disease (AD). Persons with diabetes have a higher incidence of cognitive decline and an increased risk of developing all types of dementia. Cognitive deficits in persons with diabetes mainly affect the areas of psychomotor efficiency, attention, learning and memory, mental flexibility and speed, and executive function. The strong epidemiological association has suggested the existence of a physiopathological link. The determinants of the accelerated cognitive decline in DM2, however, are less clear. Increased cortical and subcortical atrophy have been evidenced after controlling for diabetic vascular disease and inadequate cerebral circulation. Most recent studies have focused on the role of insulin and insulin resistance as possible links between diabetes and AD. Disturbances in brain insulin signaling mechanisms may contribute to the molecular, biochemical, and histopathological lesions in AD. Hyperglycemia itself is a risk factor for cognitive dysfunction and dementia. Hypoglycemia may also have deleterious effects on cognitive function. Recurrent symptomatic and asymptomatic hypoglycemic episodes have been suggested to cause sub-clinical brain damage, and permanent cognitive impairment. Future trials are required to clarify the mechanistic link, to address the question whether cognitive decline may be prevented by an adequate metabolic control, and to elucidate the role of drugs that may cause hypoglycemic episodes.

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  • Vascular risk factors including hypertension, diabetes, hyperlipidemia, and cardiovascular disease, as well as environment and lifestyle, all affect cerebrovascular and BBB dysfunction.

    “Vascular risk factors including hypertension (169, 272), diabetes (43, 110), hyperlipidemia (74), and cardiovascular disease (594), as well as environment (e.g., pollution) (87-89, 207) and lifestyle (e.g., obesity, sedentary lifestyle) (281, 643) all affect cerebrovascular and BBB dysfunction (429, 571), and may influence onset and progression of AD.”

    From Blood-Brain Barrier: From Physiology to Disease and Back (2019) · cites this paper as [43]

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Authors
Barbagallo, M.
Affiliations
University of Palermo (IT)
Corresponding author
Barbagallo, Mario
Venue
World Journal of Diabetes
Published
2014
Volume
5
Issue
6
Pages
889
ISSN
1948-9358 (ISSN-L)
OpenAlex
W1980458121
Cited by
313
References
35
Citations by year
2026: 17 · 2025: 31 · 2024: 33 · 2023: 34 · 2022: 24 · 2021: 28 · 2020: 26 · 2019: 18 · 2018: 21 · 2017: 19 · 2016: 39 · 2015: 18 · 2014: 4 · 2012: 1
FWCI
3.69
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • World Journal of Diabetes (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Nova Science Publishers (Nova Science Publishers, Inc.) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
type 2 diabetes, Alzheimer's disease, cognitive decline, dementia risk, insulin resistance, brain insulin signaling, hyperglycemia, hypoglycemia, brain atrophy, metabolic control, cognitive impairment prevention

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