Ferroptosis in diabetes-associated cognitive dysfunction: mechanisms and therapeutic potential

Diabetic-Associated Cognitive Dysfunction (DACD) is a major central nervous system complication of diabetes. Its pathogenesis involves dysfunction of the neurovascular unit, oxidative stress, and chronic neuroinflammation. Ferroptosis, an iron-dependent form of regulated cell death, is strongly implicated in DACD progression. This review synthesizes its core mechanisms, focusing on three key areas: metabolic iron overload, aberrant lipid peroxidation, and disruptions in key amino acid pathways. These processes collectively drive ferroptotic damage in vulnerable neurons of the hippocampus and cortex, ultimately leading to cognitive decline. Furthermore, this work highlights the translational potential of targeting ferroptosis using specific inhibitors (e.g., Ferrostatin-1, Deferoxamine, Erythropoietin) for DACD treatment, offering novel strategic insights for intervention. Future clinical investigations are essential to validate the efficacy of these therapeutic targets in diabetic patient populations.