Diabetes and the Brain

*Type 2 Diabetes - From Pathophysiology to Modern Management*

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**Chapter 4**

**Abstract**

**1. Introduction**

Mellitus

Cognitive Dysfunction in Diabetes

People with diabetes mellitus type 2 will have higher rate of cognitive impairment than people that do not. Besides that, the effect of diabetes on the normal mental functions is often disregarded. This may be due to a lack of signs and standard assessment technique to measure the cognitive function of the diabetes patient. Hyperglycaemia which is common in people with diabetes has been associated with an increase in the possibility of developing Alzheimer's disease and vascular dementia in the both general public and people with cognitive impairment. It has been estimated that an individual with diabetes mellitus is 1.5 times more likely to experience cognitive dysfunction and dementia than a normal healthy individual. Alleviation of microvascular complications and hypoglycaemia is the key in treat-

According to the International Diabetes Federation, diabetes is one of the largest global health emergencies of the twenty-first century and is the top 10 causes of death globally [1]. Diabetes mellitus (DM) is a disease in which the human body cannot produce sufficient amount of insulin and fails to respond to the hormone insulin that will result to the abnormal increase of glucose level in the blood circulation resulting in hyperglycaemia [2]. It is a complex metabolic disorder which can damage multiple organs in the human body [3]. DM affects or even burdens individual and communities with huge economic cost and leads to a decrease in overall productivity [4]. The complications of DM, especially type 2, can be enhanced by comorbidities such as hypertension, stroke, etc. [5]. Diabetes is the leading problem of kidney failure, lower-limb amputation and also blindness among adults [6]. In Malaysia, diabetes is one of the main public health problems and is closely related to

The World Health Organization (WHO) divides the DM into two major categories which are insulin-dependent diabetes mellitus (IDDM) or type 1 diabetes mellitus and non-insulin-dependent diabetes mellitus (NIDDM) or type 2 diabetes mellitus [8]. Approximately 90% of all diabetes cases in both developed and developing countries are NIDDM and can be found mostly in people more than 30 years old [9]. In type 1 DM, the pancreas cannot produce insulin, and the body has to completely rely on the synthetic insulin to reduce the glucose in the blood.

*Faiz Ahmed Shaikh, K.C. Bhuvan, Thet Thet Htar,* 

*Manish Gupta and Yatinesh Kumari*

ment of DM to prevent cognitive decline.

avoidable and premature death [7].

**Keywords:** diabetes, cognition, age, glucose impairment, HbA1c
