Mooradian A D
Division of Endocrinology, Diabetes and Metabolism, St. Louis University Medical School, MO 63104, USA.
Clin Neurosci. 1997;4(6):322-6.
It is now generally accepted that diabetes can alter central nervous system (CNS) function. Even in the absence of overt cerebrovascular accidents or repeated hypoglycemic reactions, uncontrolled hyperglycemia is associated with cognitive changes. These changes are documented both in patients with diabetes as well as in animal models of experimental diabetes. The cognitive impairment can be ameliorated with optimization of blood glucose control. The potential causes of CNS dysfunction in diabetes can be broadly categorized as either vascular causes including changes in the blood-brain barrier and metabolic changes. The latter causes include repeated hypoglycemic episodes, hyperglycemia, hyperosmolality, acidosis, ketosis, neuroendocrine or neurochemical changes. The other contributory causes of CNS dysfunction in diabetes include the presence of hypertension, uremia, peripheral and autonomic neuropathy and multiple drug use.
目前普遍认为，糖尿病会改变中枢神经系统（CNS）功能。即使没有明显的脑血管意外或反复的低血糖反应，血糖控制不佳的高血糖也与认知变化有关。这些变化在糖尿病患者以及实验性糖尿病动物模型中均有记录。通过优化血糖控制，认知障碍可得到改善。糖尿病中枢神经系统功能障碍的潜在原因大致可分为血管性原因，包括血脑屏障的变化和代谢变化。后者包括反复低血糖发作、高血糖、高渗状态、酸中毒、酮症、神经内分泌或神经化学变化。糖尿病中枢神经系统功能障碍的其他促成因素包括高血压、尿毒症、周围神经和自主神经病变以及多种药物的使用。
