Diabetes and dementia – the two faces of Janus

Abstract

Patients with type 2 diabetes are at high risk for cognitive decline and dementia. Despite the limited data on the possible pathogenetic mechanisms, evidence suggests that cognitive decline, and thus dementia and Alzheimer’s disease, might arise from a complex interplay between type 2 diabetes and the aging brain, including decreased insulin signalling and glucose metabolism, mitochondrial dysfunction, neuroinflammation, and vascular disease. Furthermore, there is increasing interest on the effects of antidiabetic agents on cognitive decline. There are many studies showing that antidiabetic agents might have beneficial effects on the brain, mainly through inhibition of oxidative stress, inflammation, and apoptosis. In addition, experimental studies on patients with diabetes and Alzheimer’s disease have shown beneficial effects on synaptic plasticity, metabolism of amyloid-β, and microtubule-associated protein tau. Therefore, in the present review, we discuss the effects of antidiabetic agents in relation to cognitive decline, and in particular dementia and Alzheimer’s disease, in patients with type 2 diabetes.

mRNA expression profiling of mitochondrial subunits in subjects with Parkinson’s disease

“…Environmental and food-related factors certainly correlate with the reduced risk for PD, including caffeine intake, and can positively affect the integrity of mtDNA by favoring a milder course of PD [ 39 ]. There is also evidence on how mitochondrial dysfunctions can affect neurodegenerative diseases other than PD, such as AD [ 40 , 41 ]. These neurodegenerative conditions indeed show some similarities in the impairment of enzyme activities of complex I (to which the subunits MT-ND1, MT-ND2, MT-ND3, MT-ND4, MT-ND5 and MT-ND6 belong) and complex IV (to which the subunits MT-CO1, MT-CO2, MT-CO3 belong) at the level of the frontal cortex, substantia nigra, and cerebellum.…”

Brain RAS in CNS Diseases: Beneficial Effects of Small Molecule Agonists and Inhibitors

“…Of these 90% are Type 2 leaving the remainder as Type 1. World-wide the number of Type 2 diabetic patients is estimated to be 380 million (International Diabetes Federation) [239]. This number is anticipated to increase to 430+ million by 2050.…”

Pioglitazone and Risk of Chronic Obstructive Pulmonary Disease in Patients with Type 2 Diabetes Mellitus: A Retrospective Cohort Study

“…Various acute and chronic vascular complications may set in if the metabolic dysfunctions are not appropriately corrected or controlled. Hyperglycemia triggers a pro-inflammatory status and oxidative stress in the bodies, which predispose to the development of cancer, 1 aging, 2 atherosclerosis, 2 kidney disease, 2 dementia, 3 osteoarthritis, 4 muscle wasting 4 and chronic obstructive pulmonary disease (COPD). 4,5 The pathogenetic link between T2DM and COPD may involve pro-inflammatory status, microangiopathy, glycosylation of proteins in the lung and the bronchial trees, increased risk of respiratory infection, thickening of pulmonary basal lamina and increased responsiveness of airway smooth muscle cells to contractile agents under high glucose concentrations.…”