Neuropathology of type 2 diabetes: a short review on insulin-related mechanisms

Eur Neuropsychopharmacol. 2014 Dec;24(12):1961-6. doi: 10.1016/j.euroneuro.2014.01.019. Epub 2014 Jan 30.

Abstract

Postmortem studies have shown that cerebrovascular disease (CVD) neuropathology occurs frequently in type 2 diabetes (T2D) through mechanisms associated with chronic hyperglycemia such as advanced glycation end-products (AGEs). The involvement of T2D in Alzheimer׳s disease (AD)-type neuropathology has been more controversial. While postmortem data from animal studies have supported the involvement of T2D in AD-type neuropathology through insulin mechanism that may affect the development of neuritic plaques and neurofibrillary tangles (NFTs), findings from postmortem studies in humans, of the association of T2D with AD, have been mainly negative. To complicate matters, medications to treat T2D have been implicated in reduced AD-type neuropathology. In this review we summarize the literature on animal and human postmortem studies of T2D neuropathology, mainly the mechanisms involved in hyperglycemia-related CVD neuropathology and hyperinsulinemia-related AD-type neuropathology.

Keywords: Alzheimer׳s disease; Cerebrovascular disease; Neuropathology; Review; Type 2 diabetes.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Alzheimer Disease / complications*
  • Alzheimer Disease / metabolism
  • Alzheimer Disease / pathology*
  • Animals
  • Brain / metabolism*
  • Brain / pathology*
  • Cerebrovascular Disorders / complications
  • Cerebrovascular Disorders / metabolism
  • Cerebrovascular Disorders / pathology
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / metabolism*
  • Diabetes Mellitus, Type 2 / pathology*
  • Humans
  • Hyperglycemia / complications
  • Hyperglycemia / pathology
  • Hyperinsulinism / complications
  • Hyperinsulinism / pathology
  • Insulin / metabolism*

Substances

  • Insulin