Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
damage
For centuries, clinicians have been interested in the way diabetes and psychiatric symptoms interact
with one another. Thomas Willis, in the 17th century, believed that diabetes was the result of "long
sorrow and other depressions." In the 19th century, Sir Henry Maudsley suggested, in his "The
Pathology of Mind," that "Diabetes is a disease which often shows itself in families in which insanity
prevails."
Those with schizophrenia are between 2-4x higher than the general population to develop diabetes.
Family history of type 2 diabetes is likewise much higher among first-degree relatives of individuals
with schizophrenia. The rate of impaired glucose tolerance in individuals with schizophrenia is
around 40 percent. Antipsychotic medication, a sedentary lifestyle and poor healthcare all contribute
to an increased risk of diabetes among those with schizophrenia.
Diabetes has likewise been found to cause structural and functional abnormalities in the brain.
Scientists are thus concerned about the possibility that diabetes may contribute to the onset of
dementia and cognitive dysfunction. Larger epidemiological studies make it clear that vascular
dementia and Alzheimer's disease are both more common among individuals with type 2 diabetes,
even when controlling for variables such as hypertension, dyslipidemia and cardiovascular disease.
Habitual hyperglycemia may likewise contribute to cerebral dysfunction. There appears to be an
inverse relationship to glycemic control and reasoning, learning and complex psychomotor
performance. Another study correlated elevated A1C with reduced performance on neurocognitive
tests assessing learning, memory and executive function. Patients with type 1 diabetes exhibit such
cognitive deficits in mid-life. Neurocognitive changes such as lower motor speed and psychomotor
efficiency are correlated with white matter volume reduction and microstructure alteration.
Reduction in gray matter in parts of the brain responsible for memory and language processing has
also been observed.