Sweet memories: 20 years of progress in research on cognitive functioning in diabetes

Abstract

This paper appears in a special issue of the European Journal of Pharmacology that commemorates the retirement of Professor Willem Hendrik Gispen as distinguished professor of Utrecht University and as editor of the European Journal of Pharmacology. The paper provides an overview of a research line on the impact of diabetes on cognition that we started together 20 years ago, and that continues to this day. I will report how we more or less stumbled upon this topic, that was understudied, but proved to be of definite clinical relevance. I will discuss how we tried to establish animal models, how developments from clinical and experimental studies from around the world led us to reconsider our concepts, and how findings from research on diabetic neuropathy, insulin signaling in the brain, Alzheimer's disease and dementia, and vascular disease and stroke converged and helped to create new ideas and refute others. This voyage has not ended yet, because the ultimate goal is to offer patients with diabetes treatment that can protect them against accelerated cognitive decline. Although this could take another 20 years, the research from Willem Hendrik and his group brought us an important step in the right direction.

Keywords: Alzheimer′s disease; Brain; Cognitive dysfunction; Dementia; Diabetes mellitus; Magnetic resonance imaging.