Cognitive impairment and type 2 diabetes mellitus: focus of sodium-glucose cotransporter 2 inhibitors treatment

Cognitive impairment is a significant yet often underdiagnosed complication in type 2 diabetes mellitus (T2DM) patients. This chapter provides an overview of cognitive impairment in T2DM, including its definition, types, prevalence, and risk factors. Growing evidence links diabetes with cognitive dysfunction. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have become promising antidiabetic agents with potential neuroprotective benefits. This chapter describes the pharmacological mechanisms of SGLT2 inhibitors, focusing on their role in glucose regulation and potential benefits in cognitive function. The discussion extends to the brain expression of SGLT transporters and the mechanisms by which SGLT2 inhibitors may influence neurological pathways. Additionally, we examine preclinical and clinical studies that assess the impact of SGLT2 inhibitors on cognitive function. The chapter concludes with practical implications for clinical practice, emphasizing the need for integrating SGLT2 inhibitors in T2DM management while monitoring cognitive health.