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Cognitive dysfunction in diabetes - the 'forgotten' diabetes complication: a narrative review
Åke Sjöholm1, Louise Bennet2, Peter M Nilsson3
1Department of Internal Medicine, Division of Endocrinology and Diabetology, Gävle Hospital and University of Gävle, Gävle, Sweden.
Scandinavian Journal of Primary Health Care
|January 29, 2025
Summary
Diabetes can lead to cognitive dysfunction due to issues like cerebral insulin resistance. Lifestyle changes and certain diabetes medications show promise in improving brain function and cognitive health in patients.
Area of Science:
- Neuroscience
- Endocrinology
- Metabolic Disorders
Background:
- Diabetes mellitus is associated with central nervous system complications, including premature cognitive dysfunction.
- This cognitive impairment is often linked to underlying vascular dysfunction and cerebral insulin resistance.
- Despite its clinical significance, diabetes-related cognitive dysfunction remains under-recognized.
Purpose of the Study:
- To review contemporary literature on the relationship between diabetes/prediabetes and cognitive function.
- To highlight pathogenic mechanisms and potential therapeutic strategies for diabetes-associated cognitive impairment.
Main Methods:
- A narrative review of select recent publications was conducted.
- The review focused on studies examining the interface of diabetes and cognitive function.
Main Results:
- Physical activity has demonstrated the ability to reverse brain insulin resistance, improve cognitive function, and regulate appetite.
- Pharmacological interventions, including nasal insulin, GLP-1 receptor agonists, SGLT-2 inhibitors, and PPAR-γ agonists, show promising results.
Conclusions:
- Optimizing lifestyle factors like physical activity and utilizing existing diabetes medications can improve cognitive function in diabetic patients.
- Primary healthcare must increase awareness and early detection of cognitive dysfunction in type 2 diabetes patients for better risk management.
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