Literature Review from the year 2017 in the subject Medicine - Internal
Medicine, grade: C, language: English, abstract: Dementia is a
multifaceted syndrome with a significant public health, social, and
economic burden; there are forty-four million people affected by the
disease worldwide according to the most recent estimate.The number is
projected to double by the year 2030 and to triple by 2050. Alzheimer's
disease (AD, or type-3 diabetes mellitus) and vascular dementia are the
most common forms of dementia. Lifestyle risk factors including obesity
and type 2 diabetes increase the risk for the development of both
vascular and nonvascular dementia in later life. Previous literature
reported that people with diabetes mellitus had 70% greater risk for
dementia development.Traditionally, type-2 diabetes and AD (type-3
diabetes) have been thought as independent disorders; recent literature
suggests possible links that could lead to common effective modalities
of treatment. Furthermore, the highly innervated pancreas shares many
features with the brain at molecular levels. Metformin is recommended as
the first line for the treatment of patients with type 2 diabetes
mellitus due to its effectiveness, favorable effects on lipids and
cardiovascular risks, and safety profile.The previous restriction of the
use of metformin in patients with the moderate renal disease is loosened
by the Food and Drug Organization(5,6). Thus the use of this valuable
and affordable drug is expected to increase. The American Diabetes
Association recommended the periodic measurement of vitamin B12 and
supplementation as needed to reflect the recent evidence showing the
association of long-term use of metformin and B12 deficiency.Although
the role of vitamin B12 deficiency in the development of dementia is
well-established, the role of metformin in B12 deficiency and dementia
remain to be elucidated. Insulin resistance is considered as a primary
factor for the association of diabetes melli
