Diabetes mellitus type 2 might cause mild cognitive impairment in its advanced stages, potentially progressing to dementia. Diabetic cognitive impairment (DCI) stands as a chronic complication of diabetes mellitus, with its underlying pathogenesis still remaining elusive. Research has revealed that gut microbiota dysbiosis influenced the central nervous system through the "microbiota-gut-brain axis", thereby contributing to the progression of cognitive impairment. Therefore, the regulation of gut microbiota emerges as a promising approach to the prevention and treatment of DCI. This article comprehensively reviews the mechanisms through which gut microbiota influences DCI. Furthermore, it delves into experimental studies exploring targeted therapies for gut microbiota, including probiotics, fecal microbiota transplantation, dietary and nutrient interventions, as well as traditional Chinese medicine. These studies not only address diabetes-related cognitive impairment but also consider aspects such as glycolipid metabolism and inflammation. The insights gleaned from these studies provide valuable guidance for the clinical application of gut microbiota-targeted intervention in DCI.
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