Cognitive Impairment and Diabetes: Risk Factors and Preventive Strategies

A special issue of Diabetology (ISSN 2673-4540).

Deadline for manuscript submissions: closed (15 March 2026) | Viewed by 3076

Editor


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Guest Editor
1. Vascular and Metabolic Diseases Research Group, Endocrinology Department, Son Llàtzer University Hospital, Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
2. Interdisciplinary Group in Neurodegeneration, Vascular and Metabolic Diseases, University of Balearic Islands (UIB), Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
Interests: cognition; type 2 diabetes; mild cognitive impairment; dementia; obesity; metabolism; bariatric surgery; psoriasis; food addiction; emotional eating; menopause

Special Issue Information

Dear Colleagues,

As Guest Editor of this Diabetology Special Issue titled “Cognitive Impairment and Diabetes: Risk Factors and Preventive Strategies”, I invite you to submit an original research article, systematic review, narrative review, or short communication on this timely and important topic.

This Special Issue aims to explore the relationship between diabetes mellitus and cognitive impairment, including mild cognitive decline, vascular dementia, and Alzheimer’s disease. We encourage submissions that address the underlying mechanisms—such as insulin resistance, glycemic variability, vascular damage, and inflammation—as well as studies on early detection, risk stratification, and evidence-based preventive strategies.

Research areas may include (but are not limited to) the following:

  • Epidemiological studies on cognitive impairment in people with diabetes;
  • Experimental or clinical investigations on metabolic and vascular mechanisms;
  • Interventional studies focused on pharmacologic or lifestyle-based prevention;
  • Cognitive assessment tools tailored for populations with diabetes;
  • Multidisciplinary approaches to delay or mitigate cognitive decline.

Dr. Joana Nicolau Ramis
Guest Editor

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Keywords

  • type 2 diabetes
  • metabolic syndrome
  • cognition
  • mild cognitive impairment
  • dementia
  • insulin resistance
  • neurovascular dysfunction
  • glycemic control
  • inflammation
  • Alzheimer’s disease

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Published Papers (2 papers)

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Review

10 pages, 1202 KB  
Review
Functional Assessment in Diabetic Cognitive Impairment: A Scoping Review of Activities of Daily Living Screening Tools
by Isabel Lavadinho, Nídia Calado and José Augusto Simões
Diabetology 2026, 7(6), 119; https://doi.org/10.3390/diabetology7060119 - 18 Jun 2026
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Abstract
Background: Type 2 Diabetes Mellitus (T2DM) is associated with a vascular-executive cognitive decline profile that early impacts complex daily tasks. Despite the increased risk of Mild Cognitive Impairment (MCI) in this population, there is a critical shortage of instruments specifically validated for this [...] Read more.
Background: Type 2 Diabetes Mellitus (T2DM) is associated with a vascular-executive cognitive decline profile that early impacts complex daily tasks. Despite the increased risk of Mild Cognitive Impairment (MCI) in this population, there is a critical shortage of instruments specifically validated for this group. This scoping review aims to identify the instruments used to assess functionality in individuals with T2DM and MCI and to map their psychometric properties. Methods: We conducted a scoping review based on the JBI methodology and PRISMA-ScR guidelines. The search was performed across several electronic databases (PubMed, Cochrane Library, Web of Science, Scopus and SciELO), up to March 2026, focusing on the intersection of T2DM, mild cognitive impairment, and the psychometric properties of functional scales. Results: Our search identified only three studies meeting the eligibility criteria. The functional instruments evaluated across these publications were the ADCS-ADL scale, the A-FAQ, and a predictive nomogram including the Lawton-Brody scale. Methodological approaches, sample configurations and reported outcomes varied substantially within the included literature, with no comparative validation studies conducted among homogeneous T2DM cohorts. Conclusions: The notable scarcity and marked heterogeneity of the available literature prevent any definitive conclusions regarding the comparative diagnostic superiority of current functional scales. While gradated instruments show conceptual compatibility with the executive-vascular cognitive decline profile of T2DM, their psychometric properties remain unvalidated in this specific population. Future research should prioritize longitudinal validation designs in homogeneous diabetic cohorts to standardize screening protocols calibrated to metabolic and vascular variations. Full article
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Graphical abstract

25 pages, 1586 KB  
Review
Diabetes and Gastroparesis: New Concepts and Insights
by Gaetano Leto, Pietro Crispino, Antonello Viceconti and Valentina Camardo
Diabetology 2026, 7(5), 93; https://doi.org/10.3390/diabetology7050093 - 7 May 2026
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Abstract
Diabetic gastroparesis (DGp) is a chronic complication of diabetes characterized by delayed gastric emptying with nausea, vomiting, early satiety, bloating, and poor glycemic control. Diagnosis requires objective testing, preferably a 4-h gastric emptying scan, along with assessment of symptom severity and quality of [...] Read more.
Diabetic gastroparesis (DGp) is a chronic complication of diabetes characterized by delayed gastric emptying with nausea, vomiting, early satiety, bloating, and poor glycemic control. Diagnosis requires objective testing, preferably a 4-h gastric emptying scan, along with assessment of symptom severity and quality of life for affected patients. Diabetic gastroparesis is the result of complex and overlapping mechanisms: autonomic (vagal) neuropathy, loss/dysfunction of interstitial cells of Cajal (ICC), enteric neuropathy, pyloric dysfunction (increased pyloric tone), and altered gut–brain signaling. Chronic hyperglycemia precipitates and worsens gastric dysmotility. Management remains multimodal: optimize glycemic control and nutrition, use evidence-based prokinetics and antiemetics, and consider targeted procedural/device therapies (G-POEM, gastric electrical stimulation) for refractory cases. The present is characterized by renewed drug development (ghrelin agonists such as relamorelin, with promising efficacy but a not-yet-well-established commercial pathway) and growing evidence for selective prokinetics already in use for other indications (prucalopride). Neuromodulation (Enterra GES) remains an option for selected refractory patients. Recent guidelines and studies define when and how to use these options, but no randomized head-to-head comparisons of the various therapeutic options are yet available, nor are long-term, real-world safety/efficacy registries for drugs and minimally invasive surgical procedures. There is still unsatisfactory evidence on how to safely manage GLP-1 receptor agonist therapy in diabetic patients predisposed to gastroparesis (balancing cardiorenal glycemic benefits versus gastrointestinal adverse effects), considering that these drugs can worsen gastric emptying and symptoms, requiring careful clinical judgment. This review aims to analyze and update clinicians on new evidence in the diagnosis and treatment of these conditions, starting from earlier recognition to achieving more rational treatment that balances the need for good glycemic control, control of gastrointestinal symptoms related to these complications, and an acceptable quality of life for the diabetic patient. Full article
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