Relationships between diabetes and cognitive impairment.

Epidemics of obesity, diabetes, nonalcoholic fatty liver disease, and cognitive impairment/Alzheimer disease have emerged over the past 3 to 4 decades. These diseases share in common target-organ insulin resistance with a constellation of molecular and biochemical abnormalities that lead to organ/tissue degeneration over time. This article discusses the fundamental links among these diseases and how peripheral organ insulin resistance diseases contribute to cognitive impairment and neurodegeneration. A future role of endocrinologists and diabetologists could be to provide integrative diagnostic and treatment approaches for this collection of diseases that seem to share pathophysiological and pathogenetic bases.