COGNITIVE IMPAIRMENT IN TYPE 2 DIABETES MELLITUS: PATHOPHYSIOLOGICAL MECHANISMS AND EMERGING DIAGNOSTIC APPROACHES

Abstract

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder associated with multiple systemic complications, including cognitive impairment. Increasing evidence suggests that patients with T2DM have a higher risk of memory dysfunction, reduced executive function, and dementia. Chronic hyperglycemia, insulin resistance, oxidative stress, neuroinflammation, and vascular dysfunction contribute significantly to neuronal injury and cognitive decline. Early diagnosis of cognitive impairment in diabetic patients remains challenging because neurological changes may develop gradually over many years. This review article summarizes current evidence regarding the pathophysiological mechanisms linking T2DM and cognitive dysfunction, discusses major risk factors and core blood/neuroimaging biomarkers, and highlights emerging diagnostic technologies and personalized preventive strategies. This review article provides an integrated roadmap for early clinical risk assessment and modern multimodal diagnostic models to mitigate the progression of diabetes-associated neurodegeneration.