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the study published in JAMA Network Open

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the study published in JAMA Network Open

To the numerous advantages of glycemic control in people with type 2 diabetes, today there is also a protective effect in terms of reducing the risk of developing dementia. These are the results of a research which appeared on Jama Network Open, conducted over a period of 8 years in Hong Kong, and which involved 55,618 participants: the research highlighted how the good management of patients suffering from diabetes is able to mitigate the risk of dementia in patients with T2D.

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Participants enrolled in RAMP-DM experienced a 28% reduction in the risk of all-cause dementia, a 15% decrease in the risk of Alzheimer’s disease, a significant 39% decrease in the risk of vascular dementia, and a reduction in 29% in risk of other or unspecified dementia, compared to those receiving standard care. Specifically, participants with higher levels of Hemoglobin A1C (HbA1C) had a significantly increased risk of dementia, ranging from 17% to 54%, underscoring the critical role of maintaining optimal blood glucose levels. This study also highlights the effectiveness of multidisciplinary diabetes management programs in changing the trajectory of cognitive decline. Over 27,809 patients with T2D receiving primary care services were carefully matched 1:1 with individuals receiving standard treatment, ensuring the robustness and reliability of the study results.

“SID considers these results as a fundamental step in the fight against the early development of neurodegenerative diseases among the diabetic population. This study adds another layer to the benefits of carefully monitoring blood glucose levels and raises awareness of the connection between diabetes management and cognitive health. By prioritizing and improving diabetes care, we can make significant strides in reducing the burden of dementia, improving the quality of life for millions of people around the world,” said Professor Angelo Avogaro, SID President. Excess blood sugar, a characteristic of poorly managed diabetes, can influence the development of dementia through several pathophysiological mechanisms involving various metabolic, inflammatory and vascular pathways. Mechanisms range from the formation of advanced glycation end products (AGEs) that can alter protein function and promote oxidative stress and inflammation, contributing to the pathogenesis of dementia. Chronic hyperglycemia increases oxidative stress, that is, the production of free radicals that can damage brain cells. This can lead to accelerated atherosclerosis and increase the risk of vascular dementia. Type 2 diabetes is also commonly associated with insulin resistance, which not only affects glucose metabolism but can also have direct effects on the brain. Insulin has important roles in neurotransmission, synaptic plasticity, and neuronal survival. Insulin resistance can disrupt these processes and contribute to neurodegeneration. These mechanisms do not act in isolation but influence each other, contributing to the complexity of the relationship between diabetes and dementia. Research continues to explore these links to develop more effective preventive and therapeutic strategies.

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Diabetes in Italy

Italy has an estimated prevalence of around 6-7% of the adult population, with a higher incidence in the elderly population. Incidence: The incidence of type 2 diabetes, which is the most common form, is increasing, partly due to the aging population and changes in lifestyle, including diet and physical activity. Dementia in Italy: Prevalence: The prevalence of dementia in Italy is in line with other high-income countries, with estimates indicating approximately 6-7% of the population over 65 suffers from some form of dementia. This number tends to increase as the population ages. Types of dementia: Alzheimer’s disease represents the most common cause of dementia in Italy, followed by vascular dementia and other forms of dementia. Research indicates that type 2 diabetes is a significant risk factor for developing several types of dementia, including Alzheimer’s disease and vascular dementia.

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