Encephalopathies represent a group of particular pathologies, which are characterized by a structural and functional alteration of the brain.
The various types of encephalopathy differ from each other due to the triggering causes - to which they usually owe their names - for the symptoms, for the complications, for the treatment and for the prognosis.
Congenital or acquired, an encephalopathy can last a lifetime ( permanent encephalopathy ) or may have a more or less important margin of healing ( temporary encephalopathy ).
A form of temporary encephalopathy - which can become permanent if it is not treated promptly - is the so-called diabetic encephalopathy . This occurs following a state of diabetes mellitus, both type 1 and type 2 .
Diabetes mellitus is a metabolic disorder characterized by hyperglycemia, or high blood sugar levels . The state of hyperglycemia can arise for two reasons, almost always independent, such as:
- An impediment to the normal action of insulin, which is the hormone responsible for regulating blood glucose levels in the blood. This is the case of type 2 diabetes mellitus, also called insulin-independent diabetes.
- Reduced insulin availability following the death of insulin-producing beta-pancreatic cells. This is the case of type 1 diabetes mellitus, also called diabetes-dependent.
In the long run, diabetic encephalopathy can become a severe form of dementia and cognitive disorder .
ENCEPHALOPATHY AND TYPE 2 DIABETES
In a patient with type 2 diabetes, there are more than one cause of the neurological changes typical of encephalopathy:- Hyperglycemia
- Insulin resistance . Over time, insulin resistance makes it difficult to dispose of a protein called amyloid, the accumulation of which leads to the formation, in the brain, of so-called amyloid plaques. Amyloid plaques block synaptic nerve transmission and contribute to the onset of Alzheimer's disease.
- Oxidative stress . It is due to the inability of the body's cells to eliminate oxygen free radicals.
- Microvascular inflammation, or microangiopathy . It is an inflammatory alteration of the small arterial vessels, present in the retina, kidney and brain.
ENCEPHALOPATHY AND TYPE 1 DIABETES
In individuals with type 1 diabetes, encephalopathy has different roots than the previous case.In fact, it may arise following a state of diabetic ketoacidosis - which is however linked to hyperglycemia - or insulin insufficiency - whose presence alters neurotransmission in the brain.
