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Diabetes and cognitive function:An evidence-based current perspective

World Journal of Diabetes 2023年第2期14卷 92-109页

作者： Meghna Julian Sebastian Shahanas KA Khan Joseph M Pappachan Mohammad Sadiq Jeeyavudeen School of Life Sciences Keele UniversityStoke-on-Trent ST55BGUnited Kingdom Department of Endocrinology and Metabolism Lancashire Teaching Hospitals NHS TrustPreston PR29HTUnited Kingdom Faculty of Science Manchester Metropolitan UniversityManchester M156BHUnited Kingdom Faculty of Biology Medicine and HealthThe University of ManchesterManchester M139PLUnited Kingdom Department of Endocrinology and Metabolism University Hospitals of EdinburghEdinburgh EH164SAUnited Kingdom

Several epidemiological studies have clearly identified diabetes mellitus(DM)as a major risk factor for cognitive dysfunction,and it is going to be a major public health issue in the coming years because of the alarming rise in diabetes prevalence across the *** and neural tissues predominantly depend on glucose as energy substrate and hence,any alterations in carbohydrate metabolism can directly impact on cerebral functional output including cognition,executive capacity,and *** affects neuronal function and mental capacity in several ways,some of which include hypoperfusion of the brain tissues from cerebrovascular disease,diabetes-related alterations of glucose transporters causing abnormalities in neuronal glucose uptake and metabolism,local hyper-and hypometabolism of brain areas from insulin resistance,and recurrent hypoglycemic episodes inherent to pharmacotherapy of diabetes resulting in neuronal *** decline can further worsen diabetes care as DM is a disease largely self-managed by ***,it is crucial to understand the pathobiology of cognitive dysfunction in relation to DM and its management for optimal long-term care plan for patients.A thorough appraisal of normal metabolic characteristics of the brain,how alterations in neural metabolism affects cognition,the diagnostic algorithm for patients with diabetes and dementia,and the management and prognosis of patients when they have this dangerous combination of illnesses is imperative in this *** evidence-based narrative with the backup of latest clinical trial reviews elaborates the current understanding on diabetes and cognitive function to empower physicians to manage their patients in day-to-day clinical practice.

关键词： Diabetes mellitus Dementia Cognitive function antidiabetic medications Hyperglycemia Hypoglycemia

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Management of diabesity:Current concepts

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World Journal of Diabetes 2023年第4期14卷 396-411页

作者： Maria Michaelidou Joseph M Pappachan Mohammad Sadiq Jeeyavudeen Department of Endocrinology and Metabolism Lancashire Teaching Hospitals NHS TrustPreston PR29HTUnited Kingdom Faculty of Science Manchester Metropolitan UniversityManchester M156BHUnited Kingdom Faculty of Biology Medicine and HealthThe University of ManchesterManchester M139PLUnited Kingdom Department of Endocrinology&Metabolism University Hospitals of EdinburghEdinburgh EH164SAUnited Kingdom

The global prevalence of obesity is increasing rapidly with an exponential rise in incidence of type 2 diabetes mellitus in recent years.‘Diabesity’,the term coined to show the strong interlink between obesity and diabetes,is the direct cons-equence of the obesity pandemic,and poses significant challenges in the management of the *** addressing the clinical and mechanistic complications of obesity such as metabolic-associated fatty liver disease and obstructive sleep apnoea,a rational management algorithm for diabesity cannot be *** classes of anti-diabetic medications including insulins,sulphonylureas,thiazolidinediones and meglitinides are associated with the risk of weight gain and may potentially worsen ***,appropriate selection of antidiabetic drug regimen is crucial in the medical management of *** role of non-pharmacological measures such as dietary adjustments,exercise interventions and bariatric procedures should also be ***,the importance of appropriate and optimal management of diabesity is often overlooked by medical professionals when achieving adequate glycemic control which results in inappropriate management of the disease and its *** review provides a narrative clinical update on the evidence behind the management of diabesity.

关键词： Obesity Diabesity Metabolic-associated fatty liver disease antidiabetic medications Glycemic control Metabolic surgery

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