Sakurai Takashi
Nihon Rinsho. 2014 Apr;72(4):692-6.
Diabetes increases the risk of cognitive decline including vascular dementia and Alzheimer's disease. Preventive strategy for cognitive impairment is thus needed in elderly with diabetes. To avoid brain injury in diabetic elderly patients, management of hypoglycemia, hyperglycemia, fluctuation of blood glucose, insulin resistance, and cerebral vessel disease is crucial. Recent clinical trials show hyperglycemia should be controlled with HbA1c of 7.2-7.4% for prevention of newly onset of dementia in the elderly. In contrast, little is known for target glucose levels in diabetic elderly combined with demented disease. Careful insight of hypoglycemia seems more important in the elderly. Now, a variety of pharmacological agents for treatment of diabetes is available and it seems clear that a comprehensive approach will be required in order to achieve healthy brain function.
糖尿病会增加包括血管性痴呆和阿尔茨海默病在内的认知功能衰退风险。因此，糖尿病老年人需要认知障碍的预防策略。为避免糖尿病老年患者发生脑损伤，控制低血糖、高血糖、血糖波动、胰岛素抵抗和脑血管疾病至关重要。近期临床试验表明，为预防老年人新发痴呆，应将糖化血红蛋白（HbA1c）控制在7.2 - 7.4%以控制高血糖。相比之下，对于合并痴呆症的糖尿病老年人的血糖目标水平知之甚少。在老年人中，谨慎洞察低血糖似乎更为重要。目前，有多种治疗糖尿病的药物可用，而且显然需要采取综合方法才能实现健康的脑功能。
