Aderinto Nicholas, Olatunji Gbolahan, Kokori Emmanuel, Fawehinmi Praise, Moradeyo Abdulrahmon, Igwe Stephen, Ojabo Rebecca, Alabi Badrudeen Olalekan, Okafor Emmanuel Chuka, Ologbe Damilola, Olafimihan Ayobami, Olawade David B
Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Nigeria.
Department of Medicine and Surgery, University of Ilorin, Ilorin, Nigeria.
Clin Diabetes Endocrinol. 2024 May 10;10(1):10. doi: 10.1186/s40842-024-00168-7.
This mini-narrative review explores the relationship between diabetes and dementia, focusing on the potential mitigating role of metformin in reducing cognitive decline among individuals with type 2 diabetes. The interplay of factors such as glycemic control, diabetic complications, and lifestyle influences characterises diabetes-related dementia. This review emphasises the significance of comprehensive diabetes management in addressing the heightened risk of dementia in this population. Methodologically, the review synthesises evidence from 23 studies retrieved through searches on PubMed, Embase, Google Scholar, and Scopus. Current evidence suggests a predominantly positive association between metformin use and a reduced risk of dementia in individuals with diabetes. However, the review shows the complex nature of these outcomes, revealing variations in results in some studies. These discrepancies show the importance of exploring dose-response relationships, long-term effects, and demographic diversity to unravel the complexities of metformin's impact on cognitive health. Limitations in the existing body of research, including methodological disparities and confounding variables, necessitate refined approaches in future studies. Large-scale prospective longitudinal studies and randomised controlled trials focusing specifically on cognitive effects are recommended. Propensity score matching and exploration of molecular mechanisms can enhance the validity of findings in clinical practice. From a clinical perspective, metformin can serve as a potential adjunctive therapy for individuals with diabetes at risk of cognitive decline.
这篇小型叙述性综述探讨了糖尿病与痴呆症之间的关系，重点关注二甲双胍在降低2型糖尿病患者认知能力下降方面的潜在缓解作用。血糖控制、糖尿病并发症和生活方式影响等因素的相互作用是糖尿病相关痴呆症的特征。本综述强调了全面糖尿病管理对于解决该人群中痴呆症风险增加问题的重要性。在方法上，该综述综合了通过在PubMed、Embase、谷歌学术和Scopus上检索获得的23项研究的证据。目前的证据表明，使用二甲双胍与糖尿病患者患痴呆症风险降低之间主要呈正相关。然而，该综述显示了这些结果的复杂性，揭示了一些研究结果存在差异。这些差异表明，探索剂量反应关系、长期影响和人口统计学多样性对于阐明二甲双胍对认知健康影响的复杂性很重要。现有研究的局限性，包括方法学差异和混杂变量，使得未来的研究需要改进方法。建议开展大规模前瞻性纵向研究和专门关注认知效应的随机对照试验。倾向得分匹配和分子机制探索可以提高临床实践中研究结果的有效性。从临床角度来看，二甲双胍可以作为有认知能力下降风险的糖尿病患者的一种潜在辅助治疗方法。
