Alzheimer's disease and diabetes mellitus

Recently, healthcare specialists have put great emphasis on the relationship between Alzheimer's disease and diabetes. There are many common pathogenic mechanisms underlying both diseases: insulin resistance, hyperinsulinemia, chronic hyperglycemia, acute hypoglycemic episodes, microangiopathy, inflammation, dyslipidemia, etc. It is assumed that there is a direct link between insulin and Alzheimer's disease. Insulin regulates β-amyloid synthesis as well as tau phosphorylation. Cognitive impairment and dementia associated with diabetes can also be mediated through vascular factors including, primarily, development of microangiopathy. Еру vascular and neurodegenerative components can be mutually intensified. One of the key elements in the pathogenesis of cognitive degradation is impaired cholinergic transmission. Acetylcholinesterase inhibitors are the drugs of choice for the treatment of both Alzheimer's disease and vascular dementia. The effectiveness of donepezil (Alzepil) has been proved in numerous trials: it is characterized by the best tolerability compared with other cholinergic drugs and is the only drug in the group recommended for use in severe stages of Alzheimer's disease