Insulin, C-peptide, hyperglycemia, and central nervous system complications in diabetes.
Diabetes is an increasingly common disorder which causes and contributes to a variety of central nervous system (CNS) complications which are often associated with cognitive deficits. There appear to be two types of diabetic encephalopathy. Primary diabetic encephalopathy is caused by hyperglycemia and impaired insulin action, which evolves in a diabetes duration-related fashion and is associated with apoptotic neuronal loss and cognitive decline. This appears to be particularly associated with insulin-deficient diabetes. Secondary diabetic encephalopathy appears to arise from hypoxic-ischemic insults due to underlying microvascular disease or as a consequence of hypoglycemia. This type of cerebral diabetic complication is more common in the type 2 diabetic population. Here, we will review the clinical and experimental data supporting this conceptual division of diabetic CNS complications and discuss the underlying metabolic, molecular, and functional aberrations.
Sima
Anders A F
AA
Department of Pathology, Gordon H. Scott Hall of Basic Medical Sciences, Wayne State University, 540 East Canfield Avenue, Detroit, MI 48201, USA. asima@med.wayne.edu
Kamiya
Hideki
H
Kamiya
Hideke
H
Li
Zhen Guo
ZG
D000818:Animals; D017209:Apoptosis; D002096:C-Peptide / Q000378:metabolism*; D002493:Central Nervous System Diseases / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D003071:Cognition / Q000502:physiology; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000150:complications*; D007328:Insulin / Q000378:metabolism*
D002096:C-Peptide; D007328:Insulin