Sentinel factors for mild cognitive impairment in type 2 diabetes mellitus and their interaction mechanisms: a narrative review with network analysis perspective

Type 2 diabetes mellitus (T2DM) is a global chronic metabolic epidemic, and affected patients face a 1.5-fold higher risk of mild cognitive impairment (MCI) - a reversible pre-dementia stage - than non-diabetic populations. Early identification of modifiable sentinel factors is the cornerstone of delaying cognitive decline in T2DM patients, yet traditional statistical methods cannot fully elucidate the synergistic interactions between multi-dimensional risk factors. Network analysis, a graph theory-based statistical approach, enables visualization of complex variable associations and identification of core regulatory nodes in disease networks, providing a novel perspective for MCI research. Based on our team's clinical data and comprehensive evidence synthesis, this review systematically summarizes the pathophysiological mechanisms linking T2DM and MCI, establishes an operational definition and classification framework of MCI sentinel factors in T2DM patients, elaborates the application value of network analysis in this field, and proposes concrete research paradigms for future investigation. This review aims to provide a theoretical and practical framework for the early screening, targeted intervention, and precise prevention of MCI in T2DM patients, aligning with the scope of clinical diabetes and geriatric endocrinology research.