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Emerging links between type 2 diabetes and Alzheimer's disease
Open accessAbstract
Type 2 diabetes mellitus and Alzheimer's disease are both associated with increasing age, and each increases the risk of development of the other. Epidemiological, clinical, biochemical and imaging studies have shown that elevated glucose levels and diabetes are associated with cognitive dysfunction, the most prevalent cause of which is Alzheimer's disease. Cross sectional studies have clearly shown such an association, whereas longitudinal studies are equivocal, reflecting the many complex ways in which the two interact. Despite the dichotomy, common risk and etiological factors (obesity, dyslipidemia, insulin resistance, and sedentary habits) are recognized; correction of these by lifestyle changes and pharmacological agents can be expected to prevent or retard the progression of both diseases. Common pathogenic factors in both conditions span a broad sweep including chronic hyperglycemia per se, hyperinsulinemia, insulin resistance, acute hypoglycemic episodes, especially in the elderly, microvascular disease, fibrillar deposits (in brain in Alzheimer's disease and in pancreas in type 2 diabetes), altered insulin processing, inflammation, obesity, dyslipidemia, altered levels of insulin like growth factor and occurrence of variant forms of the protein butyrylcholinesterase. Of interest not only do lifestyle measures have a protective effect against the development of cognitive impairment due to Alzheimer's disease, but so do some of the pharmacological agents used in the treatment of diabetes such as insulin (especially when delivered intranasally), metformin, peroxisome proliferator-activated receptors γ agonists, glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors. Diabetes must be recognized as a risk for development of Alzheimer's disease; clinicians must ensure preventive care be given to control and postpone both conditions, and to identify cognitive impairment early to manage it appropriately.
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“AD patients are predisposed to some complications including increased oxidative stress (Sultana et al., 2011), morbidity, mortality (Schelke et al., 2016), microvascular disease, dyslipidemia, and insulin resistance (Sridhar et al., 2015).”
From Effect of Probiotic Supplementation on Cognitive Function and Metabolic Status in Alzheimer's Disease: A Randomized, Double-Blind and Controlled Trial (2016) · cites this paper as Sridhar et al., 2015
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Akbari, E., Asemi, Z., Daneshvar Kakhaki, R., Bahmani, F., Kouchaki, E., Tamtaji, O. R., Hamidi, G. A., & Salami, M. (2016) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2016.00256 · Cited by 946
“AD patients are predisposed to some complications including increased oxidative stress (Sultana et al., 2011), morbidity, mortality (Schelke et al., 2016), microvascular disease, dyslipidemia, and insulin resistance (Sridhar et al., 2015).”
BackgroundType 2 diabetes and quality of life
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“Moreover, patients may not appreciate significant symptoms until the disease process has already exerted a negative, and potentially irreversible impact on peripheral tissues and the brain (Sperling et al., 2011; Sridhar et al., 2015).”
BackgroundInfluential
Metadata
- Authors
- Sridhar, G. R.
- Corresponding author
- Sridhar, Gumpeny R
- ORCID
- Sridhar, Gumpeny R
- Venue
- World Journal of Diabetes
- Publisher
- Baishideng Publishing Group Inc.
- Published
- 2015
- Volume
- 6
- Issue
- 5
- Pages
- 744
- ISSN
- 1948-9358 (ISSN-L)
- PMC
- PMC4458503
- OpenAlex
- W563315964
- Cited by
- 123
- References
- 65
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 5 · 2023: 8 · 2022: 19 · 2021: 7 · 2020: 14 · 2019: 14 · 2018: 11 · 2017: 12 · 2016: 13 · 2015: 8
- FWCI
- 2.02
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc
- Locations
- World Journal of Diabetes (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- type 2 diabetes, Alzheimer's disease, cognitive impairment, hyperglycemia, insulin resistance, hyperinsulinemia, obesity, dyslipidemia, sedentary lifestyle, insulin-like growth factor, butyrylcholinesterase, insulin therapy, metformin, PPARγ agonists, GLP-1 receptor agonists, DPP-4 inhibitors, dementia prevention
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