Be Alert to Diabetes Nephropathy with Cognitive Dysfunction [Letter]

Dear editor

The recent study published by Li et al¹ in the Journal of Diabetes Metab SyndrObes has aroused my great interest.In recent times, although there have been many studies on cognitive dysfunction and diverse opinions on its causes, there has been no phased progress in the treatment and prevention of cognitive dysfunction.²

First, this article mainly studied the mechanism of Yiqi Bushen Recipe (YQBS) based on network pharmacology and experimental verification in treating diabetes nephropathy with cognitive dysfunction. The data used in the study may only include information from specific databases, and there may be issues with incomplete database coverage, resulting in certain relevant targets or pathways not being included in the analysis. Sprague Dawley rats³ were used as the model in the study. Although this model is commonly used, it may not be able to completely simulate the complexity of human diabetes nephropathy with cognitive dysfunction. The article is mainly based on animal experiments and network pharmacology analysis, lacking clinical trial data to support its conclusions. We would like to further understand if there are more clinical methods to validate experimental results.

Secondly, the study mainly focused on the impact of YQBS on diabetes nephropathy and cognitive dysfunction in the short term, and the evaluation of long-term treatment effect and safety was insufficient. The study may not have fully considered the differences in individual responses to YQBS, such as genetic polymorphisms, lifestyle habits, and environmental factors. Although molecular docking can predict the interaction between drugs and targets, the results of this computer simulation need to be further validated through experiments. Although research has focused on TNF - α and IL-6, two key inflammatory factors, diabetes nephropathy and cognitive dysfunction involve multiple inflammatory factors,⁴ and the interaction and network between these factors may not be fully explored in the article.

Finally, in practical clinical applications, patients may use multiple drugs simultaneously, and the article did not discuss the potential interactions between YQBS and other drugs. We also want to know if there are more drugs with similar effects,⁵ and whether it is necessary to add or subtract drugs in clinical use.

Therefore, we hope to see the improvement and supplement of further methods in the later stage, which can improve the reliability of the research and better explain and understand the relationship between diabetes nephropathy and cognitive dysfunction.