SUMMARY

Diabetes and its treatment are associated with functional and structural disturbances in the brain. Acute disturbances are related to acute hypoglycemia or severe hyperglycemia and stroke. These acute metabolic and vascular insults to the brain are well known and beyond the scope of this chapter, which will focus on changes in cerebral function and structure that develop more insidiously. These changes are referred to as diabetic encephalopathy, a term that encompasses functional impairment of cognition, cerebral signal conduction, neurotransmission and synaptic plasticity, and underlying structural pathology associated with diabetes. The first section addresses animal studies, and focuses on the cellular and molecular events that underlie changes in cognition. The second section deals with studies in man and provides an overview of the nature and severity of the changes in cognition, and identifies groups of diabetic patients that are at particular risk of developing cognitive impairments (i.e., the very young and the old). In addition, neurophysiological and neuroimaging studies of diabetic patients will be considered. The final section of this chapter provides a practical guide to the clinical approach of a diabetic patient with complaints of cognitive dysfunction.

Key Words: Brain MRI; cognition; dementia; evoked potentials; hippocampus; learning.

Diabetes and its treatment are associated with functional and structural disturbances in the brain. Acute disturbances are related to acute hypoglycemia or severe hyperglycemia and stroke. These acute metabolic and vascular insults to the brain are well known and beyond the scope of this chapter, which will focus on changes in cerebral function and structure that develop more insidiously, referred to as diabetic encephalopathy.

Diabetes Sustenance

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