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Encephalopathies Accompanying Type 1 and Type 2 Diabetes

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Studies in Diabetes

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Abstract

Progressive encephalopathies accompany both type 1 and type 2 diabetes. Like other chronic complications, they differ in type 1 and type 2 diabetes as to their clinical pictures and underlying pathogenetic mechanisms. The encephalopathy accompanying type 1 diabetes affects learning abilities, intelligence development, and memory retrieval with adverse effects on school performances. The major underlying culprit appears to be insulin and C-peptide deficiencies with consequences as to the expression of neurotrophic factors and their receptor, neurotransmitters, and development of oxidative and apoptotic stressors. Such abnormalities lead to defects in neuronal connectivity and gray and white matter atrophies. Type 1 diabetic encephalopathy is likely to increase due to the rapidly increasing incidence of type 1 diabetes and its occurrence in increasingly younger patients. Type 2 diabetes is associated with increased incidence of dementia and Alzheimer’s disease. Underlying mechanisms include insulin resistance with hyperinsulinemia and hyperglycemia. Commonly accompanying abnormalities such as hypercholesterolemia, hypertension, and obesity perpetuate and accelerate the occurrence of dementia and Alzheimer’s disease in type 2 diabetes. Insulin resistance and elevated cholesterol levels lead to overexpression of caveolin-1 and amyloidogenic processing of amyloid precursor protein with the formation of cerebral β-amyloid in senile plaques. Amyloid accumulation and impaired insulin signaling promote the formation of tau and neurofibrillary tangles. The predicted increases in the incidence of both type 2 diabetes and dementia show parallel trends. The mechanisms underlying diabetic encephalopathies are complex and not fully understood. However, headway is being made and biologically meaningful preventive and therapeutic measures are emerging and will be discussed.

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Authors and Affiliations

  1. Departments of Pathology and Neurology, Wayne State University School of Medicine and Detroit Medical Center, 540 E. Canfield Ave., Detroit, MI, 48201, USA

    Anders A. F. Sima

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  1. Anders A. F. Sima
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Correspondence to Anders A. F. Sima .

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Editors and Affiliations

  1. Louisiana State University Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA

    Irina Obrosova

  2. Centre for Endocrinology and Metabolism, University of Brimingham, School of Clinical and Experimental Medicine, Birmingham, United Kingdom

    Martin J. Stevens

  3. Veterans Affairs Medical Center, University of Iowa, Iowa City, Iowa, USA

    Mark A. Yorek

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Sima, A.A.F. (2014). Encephalopathies Accompanying Type 1 and Type 2 Diabetes. In: Obrosova, I., Stevens, M., Yorek, M. (eds) Studies in Diabetes. Oxidative Stress in Applied Basic Research and Clinical Practice. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4899-8035-9_8

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