Li Wei, Huang Edgar, Gao Sujuan
Master of Physician Assistant Studies, School of Health and Rehabilitation Sciences, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA.
School of Informatics and Computing, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA.
J Alzheimers Dis. 2017;57(1):29-36. doi: 10.3233/JAD-161250.
Type 1 diabetes mellitus (T1DM) is a major subtype of diabetes and is usually diagnosed at a young age with insulin deficiency. The life expectancy of T1DM patients has increased substantially in comparison with that three decades ago due to the availability of exogenous insulin, though it is still shorter than that of healthy people. However, the relation remains unclear between T1DM and dementia as an aging-related disease. We conducted a systematic review of existing literature on T1DM and cognition impairments by carrying out searches in electronic databases Medline, EMBASE, and Google Scholar. We restricted our review to studies involving only human subjects and excluded studies on type 2 diabetes mellitus or non-classified diabetes. A meta-analysis was first performed on the relationship between T1DM and cognitive changes in youths and adults respectively. Then the review focused on the cognitive complications of T1DM and their relation with the characteristics of T1DM, glycemic control, diabetic complications, comorbidities, and others. First, age at onset, disease duration, and glycemic dysregulation were delineated for their association with cognitive changes. Then diabetic ketoacidosis, angiopathy, and neuropathy were examined as diabetic complications for their involvement in cognitive impairments. Lastly, body mass index and blood pressure were discussed for their relations with the cognitive changes. Future studies are needed to elucidate the pathogenesis of T1DM-related cognitive impairments or dementia.
1型糖尿病（T1DM）是糖尿病的一种主要亚型，通常在年轻时因胰岛素缺乏而被诊断出来。由于外源性胰岛素的可得性，与三十年前相比，T1DM患者的预期寿命有了显著提高，尽管仍短于健康人群。然而，T1DM与作为一种与衰老相关疾病的痴呆症之间的关系仍不明确。我们通过在电子数据库Medline、EMBASE和谷歌学术中进行检索，对关于T1DM和认知障碍的现有文献进行了系统综述。我们将综述限制在仅涉及人类受试者的研究，并排除了关于2型糖尿病或未分类糖尿病的研究。首先分别对T1DM与青少年和成年人认知变化之间的关系进行了荟萃分析。然后，综述聚焦于T1DM的认知并发症及其与T1DM的特征、血糖控制、糖尿病并发症、合并症等的关系。首先，阐述发病年龄、病程和血糖失调与认知变化的关联。然后检查糖尿病酮症酸中毒、血管病变和神经病变作为糖尿病并发症在认知障碍中的作用。最后，讨论体重指数和血压与认知变化的关系。需要进一步的研究来阐明T1DM相关认知障碍或痴呆症的发病机制。
