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Advisor(s)
Abstract(s)
Com o crescente envelhecimento da população, a preservação da função cognitiva tem vindo a ganhar particular relevância. Neste sentido, têm sido investigados alguns dos fatores com influência negativa no funcionamento cerebral, nomeadamente a diabetes. Como a diabetes tipo 2 é uma patologia sistémica com uma forte componente ambiental, atuar ao nível da sua prevenção e controlo poderá trazer benefícios na cognição a longo prazo.
Esta monografia aborda a associação entre a diabetes e a demência através de uma revisão sistemática e aprofundada de artigos publicados nos últimos dez anos. É analisada a incidência e variabilidade destes casos na população e discutido o tipo de demência provocado pela diabetes. Após uma explicação detalhada dos mecanismos subjacentes, a revisão incide na informação sobre os métodos de diagnóstico e de medidas de prevenção, de modo a reduzir a incidência de declínio cognitivo em diabéticos.
Diversos fatores amplificam o risco de demência em diabéticos tipo 2, de salientar o deficiente controlo da diabetes, o seu aparecimento precoce e a depressão. Esta doença provoca diversas modificações estruturais e funcionais, de uma forma progressiva. Estudos de neuroimagem evidenciam atrofia e redução do metabolismo da glicose, principalmente no lobo temporal médio, incluindo o hipocampo, e no lobo frontal.
Estão a decorrer ensaios clínicos sobre o efeito da medicação prescrita na diabetes na cognição. Neste âmbito, está a ser estudada uma nova via de administração da insulina, a via nasal, com o objetivo de colmatar o défice de insulina no cérebro. É fundamental que a diminuição do risco passe pela correta vigilância da diabetes e pela promoção de estilos de vida saudáveis. Com este intuito, apresenta-se um algoritmo para o diagnóstico de declínio cognitivo em diabéticos com vista à deteção precoce e seguimento destes casos, a fim de promover uma melhor qualidade de vida.
Along with the growing burden of an ageing population, the issue of cognitive function preservation has gained particular relevance. In this regard, several factors that may have negative effects on the brain function have been investigated, including diabetes. Being type 2 diabetes a systemic disease with a strong environmental component, acting at the level of its prevention and control may bring long term benefits to cognition. This dissertation addresses the association between diabetes and dementia through a systematic and exhaustive review of articles published in the last ten years. The incidence and variability of these cases in the population is analyzed and the type of dementia caused by diabetes is discussed. After a detailed explanation of the underlying mechanisms, the review focus on the existing information about methods of diagnosis and measures of prevention in order to reduce the incidence of cognitive decline in diabetics. Several factors amplify the risk of dementia in type 2 diabetics, to point out, a poor control of diabetes, its early onset and depression. This disease progressively causes various structural and functional changes. Neuroimaging studies demonstrate atrophy and reduced glucose metabolism, mainly in the medial temporal lobe, including the hippocampus, and frontal lobe. Clinical trials concerning the effect of prescribed medication in diabetes on the cognition are ongoing. In this context, a new route of insulin administration is being studied, the nasal route, in order to overcome the insulin deficit in the brain. It is fundamental that the decrease of the risk integrates the correct monitoring of diabetes and the promotion of a healthy life style. For this purpose, it is presented an algorithm of diagnosis of cognitive decline in diabetic patients for an early detection and monitoring of these cases, in order to promote a better quality of life.
Along with the growing burden of an ageing population, the issue of cognitive function preservation has gained particular relevance. In this regard, several factors that may have negative effects on the brain function have been investigated, including diabetes. Being type 2 diabetes a systemic disease with a strong environmental component, acting at the level of its prevention and control may bring long term benefits to cognition. This dissertation addresses the association between diabetes and dementia through a systematic and exhaustive review of articles published in the last ten years. The incidence and variability of these cases in the population is analyzed and the type of dementia caused by diabetes is discussed. After a detailed explanation of the underlying mechanisms, the review focus on the existing information about methods of diagnosis and measures of prevention in order to reduce the incidence of cognitive decline in diabetics. Several factors amplify the risk of dementia in type 2 diabetics, to point out, a poor control of diabetes, its early onset and depression. This disease progressively causes various structural and functional changes. Neuroimaging studies demonstrate atrophy and reduced glucose metabolism, mainly in the medial temporal lobe, including the hippocampus, and frontal lobe. Clinical trials concerning the effect of prescribed medication in diabetes on the cognition are ongoing. In this context, a new route of insulin administration is being studied, the nasal route, in order to overcome the insulin deficit in the brain. It is fundamental that the decrease of the risk integrates the correct monitoring of diabetes and the promotion of a healthy life style. For this purpose, it is presented an algorithm of diagnosis of cognitive decline in diabetic patients for an early detection and monitoring of these cases, in order to promote a better quality of life.
Description
Keywords
Demência Diabetes Fatores de Risco Prevenção