Glucose Transport and Utilization in the Hippocampus: From Neurophysiology to Diabetes-Related Development of Dementia

Caio Yogi Yonamine, Maria Luiza Estimo Michalani, Rafael Junges Moreira, Ubiratan Fabres Machado*

*Corresponding author for this work

Research output: Contribution to journalReviewResearchpeer-review

2 Citations (Scopus)
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Abstract

The association of diabetes with cognitive dysfunction has at least 60 years of history, which started with the observation that children with type 1 diabetes mellitus (T1D), who had recurrent episodes of hypoglycemia and consequently low glucose supply to the brain, showed a deficit of cognitive capacity. Later, the growing incidence of type 2 diabetes mellitus (T2D) and dementia in aged populations revealed their high association, in which a reduced neuronal glucose supply has also been considered as a key mechanism, despite hyperglycemia. Here, we discuss the role of glucose in neuronal functioning/preservation, and how peripheral blood glucose accesses the neuronal intracellular compartment, including the exquisite glucose flux across the blood–brain barrier (BBB) and the complex network of glucose transporters, in dementia-related areas such as the hippocampus. In addition, insulin resistance-induced abnormalities in the hippocampus of obese/T2D patients, such as inflammatory stress, oxidative stress, and mitochondrial stress, increased generation of advanced glycated end products and BBB dysfunction, as well as their association with dementia/Alzheimer’s disease, are addressed. Finally, we discuss how these abnormalities are accompained by the reduction in the expression and translocation of the high capacity insulin-sensitive glucose transporter GLUT4 in hippocampal neurons, which leads to neurocytoglycopenia and eventually to cognitive dysfunction. This knowledge should further encourage investigations into the beneficial effects of promising therapeutic approaches which could improve central insulin sensitivity and GLUT4 expression, to fight diabetes-related cognitive dysfunctions.

Original languageEnglish
Article number16480
JournalInternational Journal of Molecular Sciences
Volume24
Issue number22
Number of pages24
ISSN1661-6596
DOIs
Publication statusPublished - 2023

Bibliographical note

Publisher Copyright:
© 2023 by the authors.

Keywords

  • Alzheimer’s disease
  • cognitive dysfunction
  • glucose transporters
  • insulin resistance
  • obesity

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