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Gaspar JM, Baptista FI, Macedo MP, Ambrósio AF. Inside the Diabetic Brain: Role of Different Players Involved in Cognitive Decline. ACS Chem Neurosci 2016; 7:131-42. [PMID: 26667832 DOI: 10.1021/acschemneuro.5b00240] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Diabetes mellitus is the most common metabolic disease, and its prevalence is increasing. A growing body of evidence, both in animal models and epidemiological studies, has demonstrated that metabolic diseases like obesity, insulin resistance, and diabetes are associated with alterations in the central nervous system (CNS), being linked with development of cognitive and memory impairments and presenting a higher risk for dementia and Alzheimer's disease. The rising prevalence of diabetes together with its increasing earlier onset suggests that diabetes-related cognitive dysfunction will increase in the near future, causing substantial socioeconomic impact. Decreased insulin secretion or action, dysregulation of glucose homeostasis, impairment in the hypothalamic-pituitary-adrenal axis, obesity, hyperleptinemia, and inflammation may act independently or synergistically to disrupt neuronal homeostasis and cause diabetes-associated cognitive decline. However, the crosstalk between those factors and the mechanisms underlying the diabetes-related CNS complications is still elusive. During the past few years, different strategies (neuroprotective and antioxidant drugs) have emerged as promising therapies for this complication, which still remains to be preventable or treatable. This Review summarizes fundamental past and ongoing research on diabetes-associated cognitive decline, highlighting potential contributors, mechanistic mediators, and new pharmacological approaches to prevent and/or delay this complication.
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Affiliation(s)
- Joana M. Gaspar
- CEDOC,
Chronic Diseases Research Centre, NOVA Medical School/Faculdade de
Ciências Médicas, Universidade Nova de Lisboa, Edifício
CEDOC - IIRua Câmara Pestana no. 6, 6A e 6B, 1150-082 Lisboa, Portugal
- Institute
for Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Portuguese Diabetes Association (APDP), R. do Salitre 118-120, 1250-203 Lisboa, Portugal
| | - Filipa I. Baptista
- Institute
for Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- CNC.IBILI
Consortium, University of Coimbra, 3004-517 Coimbra, Portugal
| | - M. Paula Macedo
- CEDOC,
Chronic Diseases Research Centre, NOVA Medical School/Faculdade de
Ciências Médicas, Universidade Nova de Lisboa, Edifício
CEDOC - IIRua Câmara Pestana no. 6, 6A e 6B, 1150-082 Lisboa, Portugal
- Portuguese Diabetes Association (APDP), R. do Salitre 118-120, 1250-203 Lisboa, Portugal
| | - António F. Ambrósio
- Institute
for Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- CNC.IBILI
Consortium, University of Coimbra, 3004-517 Coimbra, Portugal
- AIBILI, 3000-548 Coimbra, Portugal
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Clement S, Braithwaite SS, Magee MF, Ahmann A, Smith EP, Schafer RG, Hirsch IB, Hirsh IB. Management of diabetes and hyperglycemia in hospitals. Diabetes Care 2004; 27:553-91. [PMID: 14747243 DOI: 10.2337/diacare.27.2.553] [Citation(s) in RCA: 796] [Impact Index Per Article: 39.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Stephen Clement
- Department of Endocrinology, Georgetown University Hospital, Washington, DC 20007, USA.
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