Cognitive dysfunction in type 1 diabetes mellitus

Anna Shalimova , Beata Graff , Dariusz Gąsecki , Jacek Wolf , Agnieszka Sabisz , Edyta Szurowska , Krzysztof Jodzio , Krzysztof Narkiewicz

Abstract

Context: We have summarized key studies assessing the epidemiology, mechanisms, and consequences of cognitive dysfunction (CD) in type 1 diabetes. Evidence Synthesis: In a number of studies, the severity of CD in type 1 diabetes was affected by the age of onset and duration, and the presence of proliferative retinopathy and autonomic neuropathy. Diabetes-related CD has been observed, not only in adults, but also in children and adolescents. Most neuroimaging studies of patients with type 1 diabetes did not show any differences in whole brain volumes; however, they did reveal selective deficits in gray matter volume or density within the frontal, posterior, and temporal cortex and subcortical gray matter. Studies of middle-age adults with long-standing type 1 diabetes using diffusion tensor imaging have demonstrated partial lesions in the white matter and decreased fractional anisotropy in posterior brain regions. The mechanisms underlying diabetes-related CD are very complex and include factors related to diabetes per se and to diabetes-related cardiovascular disease and microvascular dysfunction, including chronic hyperglycemia, hypoglycemia, macro- and microvascular disease, and increased inflammatory cytokine expression. These mechanisms might contribute to the development and progression of both vascular dementia and Alzheimer disease. Conclusions: Higher rates of CD and faster progression in type 1 diabetes can be explained by both the direct effects of altered glucose metabolism on the brain and diabetes-related cardiovascular disease. Because the presence and progression of CD significantly worsens the quality of life of patients with diabetes, further multidisciplinary studies incorporating the recent progress in both neuroimaging and type 1 diabetes management are warranted to investigate this problem.
Author Anna Shalimova
Anna Shalimova,,
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, Beata Graff
Beata Graff,,
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, Dariusz Gąsecki
Dariusz Gąsecki,,
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, Jacek Wolf
Jacek Wolf,,
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, Agnieszka Sabisz
Agnieszka Sabisz,,
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, Edyta Szurowska
Edyta Szurowska,,
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, Krzysztof Jodzio (FSS / IPsych / DGPsych)
Krzysztof Jodzio,,
- Division of General Psychology
, Krzysztof Narkiewicz
Krzysztof Narkiewicz,,
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Journal seriesJournal of Clinical Endocrinology & Metabolism, ISSN 0021-972X, (A 40 pkt)
Issue year2019
Vol104
No6
Pages2239-2249
Publication size in sheets0.5
ASJC Classification2704 Biochemistry, medical; 1308 Clinical Biochemistry; 1310 Endocrinology; 1303 Biochemistry; 2712 Endocrinology, Diabetes and Metabolism
DOIDOI:10.1210/jc.2018-01315
Languageen angielski
Score (nominal)40
ScoreMinisterial score = 40.0, 24-07-2019, ArticleFromJournal
Publication indicators Scopus SNIP (Source Normalised Impact per Paper): 2017 = 1.909; WoS Impact Factor: 2017 = 5.789 (2) - 2017=6.011 (5)
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