ISSN: 2451-0629
Archives of Medical Science - Atherosclerotic Diseases
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Official journal of the International Lipid Expert Panel (ILEP)
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1/2020
vol. 5
 
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abstract:
State of the art paper

Diabetes and dementia – the two faces of Janus

Athanasia K. Papazafiropoulou
1
,
Chris Koros
2
,
Andreas Melidonis 
3
,
Stavros Antonopoulos
1

1.
1st Department of Internal Medicine and Diabetes Centre, Tzaneio General Hospital, Piraeus, Greece
2.
1st Department of Neurology, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
3.
Diabetes and Cardiometabolic Centre, Metropolitan Hospital, Piraeus, Greece
Arch Med Sci Atheroscler Dis 2020; 5: e186–e197
Online publish date: 2020/07/21
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Patients with type 2 diabetes are at high risk for cognitive decline and dementia. Despite the limited data on the possible pathogenetic mechanisms, evidence suggests that cognitive decline, and thus dementia and Alzheimer’s disease, might arise from a complex interplay between type 2 diabetes and the aging brain, including decreased insulin signalling and glucose metabolism, mitochondrial dysfunction, neuroinflammation, and vascular disease. Furthermore, there is increasing interest on the effects of antidiabetic agents on cognitive decline. There are many studies showing that antidiabetic agents might have beneficial effects on the brain, mainly through inhibition of oxidative stress, inflammation, and apoptosis. In addition, experimental studies on patients with diabetes and Alzheimer’s disease have shown beneficial effects on synaptic plasticity, metabolism of amyloid-, and microtubule-associated protein tau. Therefore, in the present review, we discuss the effects of antidiabetic agents in relation to cognitive decline, and in particular dementia and Alzheimer’s disease, in patients with type 2 diabetes.
keywords:

glucagon-like peptide-1 receptor agonists, sodium-glucose co-transporter-2 inhibitors, dementia, Alzheimer’s disease, neurodegenerative diseases, type 2 diabetes

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