Impairment of the melatonergic system in the pathophysiology of diabetic encephalopathy (review)

Abstract

Objective: to analyze the scientific literature to identify the main pathophysiological mechanisms of melatonergic system disorders in the formation of diabetic encephalopathy and to highlight the possible therapeutic efficacy of melatonin (MLT). Review writing methodology. A total of 50 scientific papers were found using the Cochrane Library, PubMed, el_ibrary.ru, Medscape, and analyzed. Database search had been performed for papers published from2011 to 2023 using the keyword combination 'diabetesmellitus", "melatonergic system", "melatonin" and "diabetic encephalopathy". Conclusion. The pathophysiology of diabetic encephalopathy is not yet fully understood, and search is ongoing for novel mechanisms underlying its development, with melatonergic system dysfunction seen as a promising hypothetical mechanism. Oxidative stress, mitochondrial dysfunction, inflammation, disruption of the insulin signal transduction pathway and increased brain cell apoptosis may impair the production of MLT and trigger the melatonergic system dysfunction process. MLT is known for its marked neurotrophic effects, and its insufficiency may exacerbate cognitive impairment in diabetes mellitus.