Regulation of Diabetes: a Therapeutic Strategy for Alzheimer's Disease?

J Korean Med Sci. 2019 Dec 2;34(46):e297. doi: 10.3346/jkms.2019.34.e297.

Abstract

Accumulated evidence suggests that sporadic cases of Alzheimer's disease (AD) make up more than 95% of total AD patients, and diabetes has been implicated as a strong risk factor for the development of AD. Diabetes shares pathological features of AD, such as impaired insulin signaling, increased oxidative stress, increased amyloid-beta (Aβ) production, tauopathy and cerebrovascular complication. Due to shared pathologies between the two diseases, anti-diabetic drugs may be a suitable therapeutic option for AD treatment. In this article, we will discuss the well-known pathologies of AD, including Aβ plaques and tau tangles, as well as other mechanisms shared in AD and diabetes including reactive glia and the breakdown of blood brain barrier in order to evaluate the presence of any potential, indirect or direct links of pre-diabetic conditions to AD pathology. In addition, clinical evidence of high incidence of diabetic patients to the development of AD are described together with application of anti-diabetic medications to AD patients.

Keywords: Alzheimer's Disease; Blood Brain Barrier; Brain Inflammation; Diabetes; Insulin Signaling; Oxidative Stress.

Publication types

  • Review

MeSH terms

  • Alzheimer Disease / complications
  • Alzheimer Disease / drug therapy
  • Alzheimer Disease / pathology*
  • Amyloid beta-Peptides / metabolism
  • Astrocytes / cytology
  • Astrocytes / metabolism
  • Brain / metabolism
  • Cerebrovascular Disorders / complications
  • Cerebrovascular Disorders / pathology
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / pathology*
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Lithium Chloride / therapeutic use
  • Pioglitazone / therapeutic use

Substances

  • Amyloid beta-Peptides
  • Hypoglycemic Agents
  • Lithium Chloride
  • Pioglitazone