Dementia is a multifaceted syndrome with a significant public health, social, and economic burden; there are forty-four million people affected by the disease worldwide according to the most recent estimate.The number is projected to double by the year 2030 and to triple by 2050.
Alzheimer's disease (AD, or type-3 diabetes mellitus) and vascular dementia are the most common forms of dementia. Lifestyle risk factors including obesity and type 2 diabetes increase the risk for the development of both vascular and nonvascular dementia in later life. Previous literature reported that people with diabetes mellitus had 70% greater risk for dementia development.Traditionally, type-2 diabetes and AD (type-3 diabetes) have been thought as independent disorders; recent literature suggests possible links that could lead to common effective modalities of treatment. Furthermore, the highly innervated pancreas shares many features with the brain at molecular levels.
Metformin is recommended as the first line for the treatment of patients with type 2 diabetes mellitus due to its effectiveness, favorable effects on lipids and cardiovascular risks, and safety profile.The previous restriction of the use of metformin in patients with the moderate renal disease is loosened by the Food and Drug Organization(5,6). Thus the use of this valuable and affordable drug is expected to increase.
The American Diabetes Association recommended the periodic measurement of vitamin B12 and supplementation as needed to reflect the recent evidence showing the association of long-term use of metformin and B12 deficiency.Although the role of vitamin B12 deficiency in the development of dementia is well-established, the role of metformin in B12 deficiency and dementia remain to be elucidated.
Insulin resistance is considered as a primary factor for the association of diabetes mellitus and dementia. However, the role of insulin sensitizer in the prevention of dementia remains unclear.Furthermore, there is an increasing concern about the role of metformin in cognitive disorders.Thus we conducted this narrative review, in this study we reviewed the literature to assess the interaction of Alzheimer's disease, the gut, and its microbiome, and to assess the role of metformin and other drugs used for type 1&2 diabetes mellitus as possible therapies for the AD. The role of microbiota and fecal transplantation on cognitive disorders was also discussed.
Table of Contents
III. Introduction
IV. Prevalence &Pathogenesis of type 3 diabetes mellitus
V. Proposed Treatment for type 3 diabetes (AD)
VI. Metformin and type 3 diabetes mellitus
VII. The intestinal microbiota and type 3 diabetes mellitus
VIII. Probiotics, gut microbiota, and Alzheimer's disease
IX. Conclusions
X. Recommendations
Objectives and Research Focus
This work aims to investigate the complex interactions between type 2 diabetes, type 3 diabetes (Alzheimer's disease), and the gut microbiota. It examines the potential role of current anti-diabetic medications, particularly metformin, as therapeutic interventions for cognitive disorders, while analyzing the gut-brain axis and the influence of probiotics and microbiota transplantation on disease progression.
- The link between type 2 diabetes, insulin resistance, and Alzheimer's disease.
- The impact of metformin on neurocognitive functions and B12 metabolism.
- Mechanisms of the gut microbiota in modulating systemic and neuroinflammation.
- The therapeutic potential of probiotics and bacteriophages in managing metabolic and cognitive decline.
- Future strategies for interdisciplinary treatment approaches in type 3 diabetes.
Excerpt from the Book
Chapter 5. The intestinal microbiota and type 3 diabetes mellitus
The human intestine contains more than 100000 billion bacteria; various factors affect the composition of bacteria including age, geographical location, diet, exercise, weight, metabolic (formerly bariatric) surgery, and metformin. The bacteria play a vital role in insulin sensitivity and gut integrity. Although in its infancy, the composition of microbiota and the specific role in the promotion or prevention of diseases is in progress (Clostridium ramosum and Enterococcus cloacae versus bifidobacteria and Akkermansiamuciniphila (77,78)). Microbiota affects various organs, it had been shown that a cross-talk is present in the brain and the microbiota. It is interesting to note that children born by cesarean section are at a higher risk of type 2 diabetes due to altered gut microbiota.
Diabetes mellitus type 2 and AD are highly prevalent disease and are causes of much health concern. The diseases historically share the same molecular pathology, but the exact mechanisms remain to be elucidated. The significant attention raised due to the alarming increase of both type 2 &3 diabetes mellitus, the great socioeconomic burden, and the lack of precise early diagnostic methods for an effective therapy and prevention are reasons for innovative curative approaches including the bacteriophage and nanotechnology. The available drugs for the treatment of both type 2&3 diabetes mellitus have several limitations:
Summary of Chapters
III. Introduction: This chapter introduces dementia as a global health crisis and establishes the theoretical link between type 2 diabetes, Alzheimer's disease (type 3 diabetes), and insulin resistance.
IV. Prevalence &Pathogenesis of type 3 diabetes mellitus: This section explores the metabolic nature of Alzheimer's disease, focusing on glucose regulation, amyloid beta plaques, and the shared pathological features with diabetes.
V. Proposed Treatment for type 3 diabetes (AD): This chapter evaluates various pharmacological interventions, including intranasal insulin and thiazolidinediones, as potential strategies for mitigating neuro-cognitive dysfunction.
VI. Metformin and type 3 diabetes mellitus: The chapter critically reviews the controversial role of metformin in cognitive health, discussing both its neuroprotective potential and its association with B12 deficiency.
VII. The intestinal microbiota and type 3 diabetes mellitus: This chapter examines the gut-brain axis, discussing how microbial composition influences systemic inflammation and potentially contributes to the pathogenesis of Alzheimer's disease.
VIII. Probiotics, gut microbiota, and Alzheimer's disease: The author discusses how probiotic supplementation and microbiota transplantation may modulate immune responses and potentially slow the progression of neurodegenerative conditions.
IX. Conclusions: The final section synthesizes the evidence regarding metabolic therapies and emphasizes the need for multi-targeted strategies to address the complexity of type 3 diabetes.
X. Recommendations: The work concludes by suggesting future research directions, particularly focusing on longitudinal human studies and the potential of microbiome-targeted therapies.
Keywords
Alzheimer's disease, type 2 diabetes, type 3 diabetes, gut microbiota, metformin, insulin resistance, neuroinflammation, probiotics, brain-gut axis, cognitive impairment, bacteriophage, metabolic syndrome, amyloid beta, B12 deficiency, neurodegeneration.
Frequently Asked Questions
What is the core focus of this research?
The work focuses on the intersection of type 2 diabetes and Alzheimer's disease (type 3 diabetes), specifically exploring how gut microbiota and anti-diabetic medications like metformin influence this relationship.
What is "type 3 diabetes"?
Type 3 diabetes is a term proposed for Alzheimer's disease, recognizing that it shares key cellular and molecular pathological features with diabetes, particularly regarding insulin resistance in the brain.
What is the primary research goal?
The study aims to assess the interaction between the gut microbiome and the development of Alzheimer's disease, while evaluating whether drugs typically used for diabetes could serve as effective therapies for cognitive disorders.
Which scientific methods are discussed in the context of treatment?
The author discusses a range of interventions, including pharmacological treatments (metformin, GLP-1 agonists), dietary modifications (Mediterranean diet), and emerging biotechnological approaches like probiotics, bacteriophages, and fecal transplantation.
What does the book cover in its main sections?
The book covers the epidemiology and pathogenesis of type 3 diabetes, reviews current and proposed treatments, analyzes the controversial role of metformin, explores the gut-microbiota-brain axis, and examines probiotics as a potential therapy.
Which keywords define this work?
Key terms include type 3 diabetes, Alzheimer's disease, metformin, gut microbiota, insulin resistance, neuroinflammation, and probiotics.
How does metformin affect the gut microbiota?
Metformin has been shown to shift the structure of the intestinal microbiota, increasing the abundance of butyrate-producing bacteria and reducing certain taxa associated with obesity, which may contribute to its metabolic benefits.
What is the link between B12 and metformin?
Chronic use of metformin is associated with B12 deficiency, which can cause or exacerbate cognitive impairment; therefore, the author recommends periodic monitoring and supplementation when necessary.
Is there a connection between periodontitis and type 3 diabetes?
Yes, the work notes that periodontitis is a treatable condition linked to both type 2 diabetes and Alzheimer's, as the associated systemic inflammation and neuroinflammation may contribute to cognitive decline.
- Arbeit zitieren
- Hyder Mirghani (Autor:in), 2017, The interaction of type 2 diabetes, type 3 diabetes (Alzheimer's disease), and the gut microbiota, München, GRIN Verlag, https://www.grin.com/document/383683
