Type 2 diabetes mellitus and cognitive function: understanding the connections

Abstract

Purpose of reviewTo review the connection between type 2 diabetes and cognitive dysfunction, including its epidemiology, potential mechanisms of pathophysiology, risk factors, possible prevention, and treatment considerations.Recent findingsDiabetes is a risk factor for mild cognitive decline, in addition to Alzheimer's disease and vascular dementia. Duration of diabetes, concomitant vascular or associated co-morbidities, hyper- and hypoglycemia may lead to worsening cognitive dysfunction. Unfortunately, there is a lack of evidence-based guidance on the prevention of cognitive dysfunction in the diabetes population. Studies of diabetes medications, including metformin, glucagon-like peptide-1 (GLP-1) receptor agonists, and sodium-glucose cotransporter-2 inhibitors (SGLT2) have shown some benefit with cardiovascular morbidity and may affect cognition. In the absence of clearly defined preventive tools, diabetes practice guidelines recommend annual cognitive screening as standard of care in adults with diabetes aged 65 years or older.SummaryPeople living with diabetes are at risk for significant decline in cognitive function. Epidemiology and risk factors are well defined. Prevention and treatment strategies are limited and require further study.

Association of hypoglycemic events with cognitive impairment in patients with type 2 diabetes mellitus: Protocol for a dose-response meta-analysis

“…The results of the study will facilitate the development of personalized glycemic control strategies for patients with different conditions of T2DM, and hopefully improve the prevention strategies for different types of cognitive dysfunction related to diabetes. Many medical staff working on the clinical front line have observed that people with frequent hypoglycemic events seem to be more likely to develop cognitive impairment [42]. The association between hypoglycemia incidents and cognitive impairment in terms of doseresponse hasn't been explored, though.…”

The role of neurovascular coupling dysfunction in cognitive decline of diabetes patients

“…Diabetes is a risk factor for cognitive decline. Moreover, as the disease progresses, complications emerge, and blood glucose control deteriorates, the risk of developing cognitive impairment increases ( Dao et al, 2023 ; Sakib et al, 2023 ). Cognitive impairment, in turn, negatively impacts patients’ self-care and blood glucose management, fostering a vicious cycle ( Sinclair and Abdelhafiz, 2020 ).…”

Gender difference as the risk of diabetic foot ulcers in T2DM patients: a meta-analysis

“…Muscles and bones may get affected in severe cases to cause tissue necrosis and amputation. DF is thus the most serious complication of diabetes, and about 1/3 of diabetes patients possess infection risk [4]. Diabetes foot ulcer (DFU) may occur as the disease progresses [5].…”