Risk Factors: Diabetes

Increased mortality and morbidity associated with diabetes arises from its complications, all of which have a prominent vascular component. Cerebral complications of diabetes including stroke and cognitive impairment are the least studied complications of the disease. Diabetes not only increases the risk but also worsens the progression and outcome of these diseases. Although underlying reasons are multifactorial, experimental models have revealed that diabetes mediates pathological changes in the cerebrovascular structure and function that may explain some of the clinical observations. Early vascular dysfunction initiates a perpetual cascade of cerebral perfusion abnormalities leading to pathological remodeling and neovascularization of the cerebrovasculature as well as development of neuronal dysfunction. Collectively, these changes contribute to development of cognitive impairment and occurrence of stroke, which worsens cognitive and motor deficits. Thus early interventions to improve cerebrovascular function have the potential to limit the devastating cerebral complications of diabetes.