Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK.
Lancet. 2012 Jun 16;379(9833):2291-9. doi: 10.1016/S0140-6736(12)60360-2. Epub 2012 Jun 9.
Cognitive dysfunction in type 1 and type 2 diabetes share many similarities, but important differences do exist. A primary distinguishing feature of type 2 diabetes is that people with this disorder often (but not invariably) do poorly on measures of learning and memory, whereas deficits in these domains are rarely seen in people with type 1 diabetes. Chronic hyperglycaemia and microvascular disease contribute to cognitive dysfunction in both type 1 and type 2 diabetes, and both disorders are associated with mental and motor slowing and decrements of similar magnitude on measures of attention and executive functioning. Additionally, both types are characterised by neural slowing, increased cortical atrophy, microstructural abnormalities in white matter tracts, and similar, but not identical, changes in concentrations of brain neurometabolites. Disconcertingly, the rapid rise in obesity and type 2 diabetes in all age groups might result in a substantial increase in prevalence of diabetes-related cognitive dysfunction.
1 型和 2 型糖尿病的认知功能障碍有许多共同之处，但也存在重要的差异。2 型糖尿病的一个主要区别特征是，患有这种疾病的人在学习和记忆方面的表现通常（但并非总是如此）较差，而 1 型糖尿病患者很少出现这些领域的缺陷。慢性高血糖和微血管病变是 1 型和 2 型糖尿病认知功能障碍的共同原因，两种疾病都与精神和运动迟缓以及注意力和执行功能测量中相似但幅度不同的缺陷有关。此外，两种类型都表现为神经减慢、皮质萎缩增加、白质束的微观结构异常以及脑神经代谢物浓度的相似但不相同的变化。令人不安的是，所有年龄段肥胖和 2 型糖尿病的迅速增加可能导致与糖尿病相关的认知功能障碍的患病率大幅增加。
