Alkasabera Almothana, Onyali Chike B, Anim-Koranteng Comfort, Shah Hira E, Ethirajulu Aarthi, Bhawnani Nitin, Mostafa Jihan A
General Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Internal Medicine, EHA Clinics, Abuja, NGA.
Cureus. 2021 Nov 1;13(11):e19176. doi: 10.7759/cureus.19176. eCollection 2021 Nov.
Type-2 diabetes mellitus prevalence is constantly increasing; this is explained by the increase of its risk factors and the amelioration of its management. Therefore, people are living longer with diabetes mellitus, which, in turn, has revealed new complications of the disease. Dementia is represented mainly by Alzheimer's disease and is an interesting topic of study. Accordingly, statistics have shown that dementia incidence is doubled in diabetic patients. The establishment of a relation between type-2 diabetes mellitus was studied on several levels in both humans and animal subjects. First, insulin receptors were found in the brain, especially the hippocampus, and insulin transport to the brain is mainly accomplished through the blood-brain barrier. Secondly, several studies showed that insulin affects multiple neurotransmitters in favor of promoting memory and cognition status. Thirdly, multiple pathological studies showed that insulin and Alzheimer's disease share many common lesions in the brain, such as beta-amyloid plaques, amylin-Aβ plaques, hyper-phosphorylated tau protein, and brain atrophy, especially in the hippocampus. After recognizing the positive effect of insulin on cognitive status, and the harmful effect of insulin resistance on cognitive status, multiple studies were focused on the role of anti-diabetes medications in fighting dementia. Consequently, these studies showed a positive impact of oral anti-diabetes medication, as well as insulin in limiting the progression of dementia and promoting cognitive status. Moreover, their effects were also noticed on limiting the pathological lesions of Alzheimer's disease. Accordingly, we can consider type-2 diabetes mellitus as a risk factor for dementia and Alzheimer's disease. Therefore, this can be used on the pharmaceutical level by the promising implication of antidiabetics as a treatment of dementia and Alzheimer's disease or at least to limit its progression. However, multiple clinical studies should be dedicated to proving the true benefits of anti-diabetes medications in treating dementia before they can be used in reality.
2型糖尿病的患病率在持续上升，这是由其危险因素的增加以及治疗手段的改善所导致的。因此，糖尿病患者的寿命延长了，而这反过来又揭示了该疾病的新并发症。痴呆症主要由阿尔茨海默病构成，是一个有趣的研究课题。相应地，统计数据表明糖尿病患者患痴呆症的几率翻倍。人们在人类和动物受试者的多个层面上研究了2型糖尿病与痴呆症之间的关系。首先，在大脑中发现了胰岛素受体，尤其是在海马体中，胰岛素向大脑的转运主要通过血脑屏障来完成。其次，多项研究表明胰岛素对多种神经递质有影响，有助于促进记忆和认知状态。第三，多项病理学研究表明，胰岛素和阿尔茨海默病在大脑中存在许多共同病变，如β淀粉样斑块、胰岛淀粉样多肽 - Aβ斑块、过度磷酸化的tau蛋白以及脑萎缩，尤其是在海马体中。在认识到胰岛素对认知状态的积极作用以及胰岛素抵抗对认知状态的有害作用之后，多项研究聚焦于抗糖尿病药物在对抗痴呆症方面的作用。因此，这些研究表明口服抗糖尿病药物以及胰岛素在限制痴呆症进展和促进认知状态方面具有积极影响。此外，它们在限制阿尔茨海默病的病理病变方面的作用也得到了关注。因此，我们可以将2型糖尿病视为痴呆症和阿尔茨海默病的一个危险因素。因此，在药物层面上，可以通过使用抗糖尿病药物来有望治疗痴呆症和阿尔茨海默病，或者至少限制其进展。然而，在实际应用之前，需要进行多项临床研究来证明抗糖尿病药物治疗痴呆症的真正益处。
