Dear Toljan,

First of all I appreciate you for asking such brain storming questions. The questions highlight your interest in the subject. I would like to answer a few of youur queries:

1/ Diabetes is basically a microangiopathy causing damage at the level of micro-vessels. These microvascular damage predisposes to micro-infarcts that may eventually lead to the development of vascular dementia. Hypertension is considered to be a more damaging risk factor for vascular dementia than diabetes. So, microangiopathy can a link between diabetes and vascular dementia.

2/ Though we do not have guidelines available today that recommend us to do this cognitive testing in diabetic patients. But it is advisable that if a diabetic patient presents with some neurological deficit of any kind, that patient must be checked for cognitive testing as well. We may have to wait for sometime and see the upcoming guidelines on this subject.

3/ Research is going on on this subject. And a substantial amount of research and evidence will be needed before declaring AD as DM type 3. As more and more pathophysiological processes become evident, we may be in a better position to describe an underlying relationship between these identities.

5/ Every research is done with a background and with a clearlt defined objective. So, it is quite possible that recent and future studies may be done with this point in mind to check cognitive status of the diabetic patients. 

Your post may turn out to a brain storming key for researchers on the subject and may lead to incorporation of your novel ideas in future studies.

hi Toljan, I am also interested in these findings. In fact i posted one question in the same context. But could not get answers. as far as i have studied the matter and discussed with the diabetelogists; They say that the cognitive impairment is very late complication of Diabetes ;last in the list of complications of DM. And as the duration and age goes on progressing it is difficult to say that cognitive impairment is due to DM or age . 

There are few studies in Type 1 DM ; if we can proceed in this line we can find out some corelation. I have changed my topic as comparison between Type 1 DM, Type 2DM and non diabetic.

In my opinion, yes due to discirculatory encephalopathy

Yes, diabetes is linked with dementia.  But it's not just blood sugar levels that are etiologic.  Diabetes is frequently accompanied by dyslipidemia and/or hypertension, either of which can be complicated by cigarette smoking.  All these factors must be treated to avoid dementia.  The link with all of these factors and dementia is atherothrombotic disease.

Yes, diabetes is certainly linked with dementia and in the long run would culminate into Alzeimer disease.

The damage to enzymes, especially those of the aldehydes metabolism, is it.

Enrichment of acetaldehyde in Caucasians since 1983: http://umweltbund.de/lebensmittel.htm#AldehydeimBlut

I reiterate my eatlier comment that mentioned a strong possibility that diabetes would culmintate in dementia and ultimately in alzeimer disease. Inyerrelationship between various metabolic pathways would explain the underlying causes.

Dear Karlo,

This issue is very interesting to me too. There is much evidence that there is a link between diabetes and Alzheimer disease (AD). Aside from the injurious effects on peripheral systems, diabetes also has deleterious effects on brain function. Thus, cognitive function, learning and memory problems are often observed in both type 1 and type 2 diabetes. These changes have also been found in patients with the metabolic syndrome, suggesting that factors such as insulin resistance, hypertension and dyslipidemia are involved. there is an interplay between may contributing factors.

1. Evidence for changes in brain structure and functioning accompanying cognitive dysfunction is accumulating. Atrophy of the hippocampus, a structure important for learning and memory, and surrounding structures is commonly found in T2DM and may be related to the memory and learning problems noted in these patients.

2. Moreover, chronic hyperglycemia and associated microvascular disease appear to be the most important determinants.

3. Insulin resistance has been characterized in muscle, adipose tissue and liver and can affect brain function; the question remains as whether the insulin resistance seen in peripheral tissue also occurs in the brain tissue. Additionally, studies suggest that insulin resistance in the brain is a major contributing factor to the symptoms of AD.

Hmm, before the diagnosis of diabetes, all patients known to me were suffering from aldehyde metabolism. Many of them also cause damage to the H2O2 metabolism (e. g. Hashimoto).

Among other things, proline biosynthesis is dependent on the aldehyde metabolism (ALDH18xxx).

TGA depends on the proline metabolism.

Obviously, all those affected with this enzyme damage seem to have "gluten intolerance" or, ultimately, celiac disease.

The TGA will probably remain permanently active as long as the proline biosynthesis cannot be completed.

Now EC 1.2.4.2 is not only the direct target of "inhibitors" of the aldehyde and hydrogen peroxide metabolism but especially of their now enriched acetaldehyde, a (permanently) active TGA as well as of H2O2.

Translated with www.DeepL.com/Translator

According to me " No ". No direct association exists.

Vascular dementia is due to atherothrombotic disease (ATD) risk factors and the main ATD risk factors are cigarette smoking, dyslipidemia, and hypertension, with some contribution by the very high blood sugars of uncontrolled diabetes. Diabetes includes all of these risk factors, and hence is related to vascular dementia.

Kindly see the following RG link.

Article Diabetes mellitus and cognitive impairments

I still think that no direct association exists between the two.

Atherothrombotic disease (ATD) is a major risk factor for vascular dementia and diabetes contributes to this via associated dyslipidemia and hypertension--but also by clogging up the small arteries with advanced glycosylated end products.