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Is Type 2 diabetes mellitus associated with an increased pathological burden in clinically and pathologically diagnosed Alzheimer's dementia?

Epidemiological evidence suggests that Alzheimer’s disease (AD) and Type‐2 Diabetes Mellitus (T2DM) share pathophysiological processes. T2DM causes central insulin resistance, which generates a hypoglycemic microenvironment in the brain. The oxidative stress established as a result leads to mitochondrial dysfunction, inflammation, advanced glycation end‐product (AGE) production, insulin receptor signaling pathway impairment, and insulin‐degrading enzyme (IDE) inhibition. These widespread repercussions catalyze amyloid‐β (Aβ) plaque and neurofibrillary tangle (NFT) formation. Here, we hypothesize that T2DM is associated with an increased AD pathological burden in clinically‐ and pathologically‐diagnosed AD.