Turkiye Klinikleri Journal of Health Sciences

.: REVIEW
Alzheimer Hastalığı-Tip 3 Diyabet: Geleneksel Derleme
Alzheimer Disease-Type 3 Diabetes: Traditional Review
Bilge TEKİNa, Funda ELMACIOĞLUb, Mutlu Tuçe ÜLKERb
aİstinye Üniversitesi Lisansüstü Eğitim Enstitüsü, Beslenme ve Diyetetik ABD, İstanbul, Türkiye
bİstinye Üniversitesi Sağlık Bilimleri Fakültesi, Beslenme ve Diyetetik Bölümü, İstanbul, Türkiye
Turkiye Klinikleri J Health Sci. 2023;8(1):153-60
doi: 10.5336/healthsci.2022-94043
Article Language: TR
Full Text
ÖZET
 Bulaşıcı olmayan kronik hastalıklar, 21. yüzyılın en önemli sağlık sorunlarındadır. Yaşlanan nüfusla birlikte artan diyabet ve Alzheimer hastalığı prevalansı bu 2 hastalığın bağlantılı olup olmadığını akıllara getirmektedir. Aslında farklı hastalıklarmış gibi değerlendirilen bu 2 hastalık ortak patolojilere sahiptir. Oksidatif stres, mitokondriyal disfonksiyon, periferik ve santral inflamasyon Alzheimer hastalığının etkenlerindendir. İnsülin direncinin demans ve Alzheimer hastalığının patolojisinde rol oynadığı kanıtlanmıştır. Diyabet hastalığında gözlenen insülin eksikliği veya insülin inaktivitesi, bozulmuş glukoz metabolizması ve bunlara bağlı olarak oluşan oksidatif stres hücre hasarına neden olmaktadır. Kanda yüksek seviyelerde bulunan glukozun hücre glikozilasyonuna neden olmasıyla beyinde meydana gelen hücre hasarları ve glikozilasyonu, amiloid plaklarının oluşması, tau proteininin hatalı fosforilasyonu sonucu oluşan nörofibrillerin birikmesi ile Alzheimer hastalığı olarak karşımıza çıkmaktadır. Beyinde birikmiş beta amiloid plakları ve hiperfosforilasyonlu tau proteinleri, nöron içinde ve nöronlar arasındaki iletilerin engellenmesine neden olmaktadır. İnsülin eksikliği ya da insülin inaktivitesine bağlı olarak beyinde enerji eksikliği de meydana gelmektedir. Bundan dolayı Alzheimer hastalığı için kullanılan 'Tip 3 diyabet' terimi ortaya çıkmıştır. 'Alzheimer hastalığı Tip 3 diyabet midir?' sorusu henüz netlik kazanmamış olmakla birlikte, yapılan birçok çalışma bunu desteklemektedir. Bu 2 hastalığın bağlantılı olması, diyabet ve Alzheimer hastalığında beyinde gözlenen insülin ve glukoz metabolizmasındaki bozukluklar ile ilişkilendirilir. Bu derlemede, Alzheimer hastalığı ve diyabet arasındaki ilişkinin kanıtlar doğrultusunda gözden geçirilmesi amaçlanmıştır.

Anahtar Kelimeler: Alzheimer hastalığı; diabetes mellitus, noninsüline bağımlı, 2; diyabetik nöropatile
ABSTRACT
 Noncommunicable chronic diseases are among the most important health problems of the 21st century. Increasing diabetes and Alzheimer's disease prevalence with the aging population suggests whether these 2 diseases are related. In fact, these 2 diseases, which are considered as different diseases, have common pathologies. Oxidative stress, mitochondrial dysfunction, peripheral and central inflammation are the causes of Alzheimer's disease. It has been proven that insulin resistance plays a role in the pathology of dementia and Alzheimer's disease. Insulin deficiency or insulin inactivity observed in diabetes causes impaired glucose metabolism and related oxidative stress cell damage. Alzheimer's disease occurs as a result of cell damage and glycolysis, the formation of amyloid plaques, and the accumulation of neurofibrils caused by improper phosphorylation of the tau protein due to the high levels of glucose in the blood causing cell glycolysis. Beta amyloid plaques and hyperphosphorylated tau proteins accumulated in the brain cause inhibition of transmissions within and between neurons. There is also a lack of energy in the brain due to insulin deficiency or insulin inactivity. That is why it came up with the term 'Type 3 diabetes' used for Azheimer's disease. 'Is Alzheimer's disease Type 3 diabetes?' although the question has not been clarified yet, many studies support this. The association of these 2 diseases is associated with disorders in insulin and glucose metablysis observed in the brain in diabetes and Alzheimer's disease. In this review, it is aimed to review the relationship between Alzheimer's disease and diabetes in line with the evidence.

Keywords: Alzheimer disease; diabetes mellitus, noninsulin-dependent, 2; diabetic neuropathies
REFERENCES:
  1. Burillo J, Marqués P, Jiménez B, González-Blanco C, Benito M, Guillén C. Insulin resistance and diabetes mellitus in Alzheimer's disease. Cells. 2021;10(5):1236. [Crossref]  [PubMed]  [PMC] 
  2. Rojas M, Chávez-Castillo M, Bautista J, Ortega Á, Nava M, Salazar J, et al. Alzheimer's disease and type 2 diabetes mellitus: Pathophysiologic and pharmacotherapeutics links. World J Diabetes. 2021;12(6):745-66. [Crossref]  [PubMed]  [PMC] 
  3. Patel VN, Chorawala MR, Shah MB, Shah KC, Dave BP, Shah MP, et al. Emerging pathophysiological mechanisms linking diabetes mellitus and Alzheimer's disease: an old wine in a new bottle. J Alzheimers Dis Rep. 2022;6(1):349-57. [Crossref]  [PubMed]  [PMC] 
  4. Silveira AC, Dias JP, Santos VM, Oliveira PF, Alves MG, Rato L, et al. The action of polyphenols in diabetes mellitus and Alzheimer's disease: a common agent for overlapping pathologies. Curr Neuropharmacol. 2019;17(7):590-613. [Crossref]  [PubMed]  [PMC] 
  5. Maciejczyk M, Żebrowska E, Chabowski A. Insulin resistance and oxidative stress in the brain: what's new? Int J Mol Sci. 2019;20(4):874. [Crossref]  [PubMed]  [PMC] 
  6. Kandimalla R, Thirumala V, Reddy PH. Is Alzheimer's disease a type 3 diabetes? A critical appraisal. Biochim Biophys Acta Mol Basis Dis. 2017;1863(5):1078-89. [Crossref]  [PubMed]  [PMC] 
  7. He Z, You G, Liu Q, Li N. Alzheimer's disease and diabetes mellitus in comparison: the therapeutic efficacy of the vanadium compound. Int J Mol Sci. 2021;22(21):11931. [Crossref]  [PubMed]  [PMC] 
  8. Ott A, Stolk RP, van Harskamp F, Pols HA, Hofman A, Breteler MM. Diabetes mellitus and the risk of dementia: The Rotterdam Study. Neurology. 1999;53(9):1937-42. [Crossref]  [PubMed] 
  9. Ott A, Stolk RP, Hofman A, van Harskamp F, Grobbee DE, Breteler MM. Association of diabetes mellitus and dementia: the Rotterdam Study. Diabetologia. 1996;39(11):1392-7. [Crossref]  [PubMed] 
  10. Ohara T, Doi Y, Ninomiya T, Hirakawa Y, Hata J, Iwaki T, et al. Glucose tolerance status and risk of dementia in the community: the Hisayama study. Neurology. 2011;77(12):1126-34. [Crossref]  [PubMed] 
  11. Ahtiluoto S, Polvikoski T, Peltonen M, Solomon A, Tuomilehto J, Winblad B, et al. Diabetes, Alzheimer disease, and vascular dementia: a population-based neuropathologic study. Neurology. 2010;75(13):1195-202. [Crossref]  [PubMed] 
  12. Xu W, Caracciolo B, Wang HX, Winblad B, Bäckman L, Qiu C, et al. Accelerated progression from mild cognitive impairment to dementia in people with diabetes. Diabetes. 2010;59(11):2928-35. [Crossref]  [PubMed]  [PMC] 
  13. Hayden KM, Zandi PP, Lyketsos CG, Khachaturian AS, Bastian LA, Charoonruk G, et al; Cache County Investigators. Vascular risk factors for incident Alzheimer disease and vascular dementia: the Cache County study. Alzheimer Dis Assoc Disord. 2006;20(2):93-100. [Crossref]  [PubMed] 
  14. Akomolafe A, Beiser A, Meigs JB, Au R, Green RC, Farrer LA, et al. Diabetes mellitus and risk of developing Alzheimer disease: results from the Framingham Study. Arch Neurol. 2006;63(11):1551-5. [Crossref]  [PubMed] 
  15. Bendlin BB. Antidiabetic therapies and Alzheimer disease. Dialogues Clin Neurosci. 2019;21(1):83-91. [Crossref]  [PubMed]  [PMC] 
  16. World Health Organization [Internet]. © 2020 WHO. [Cited: March 05, 2020]. Dementia. Available from: [Link] 
  17. Morovic S, Budincevic H, Govori V, Demarin V. Possibilities of dementia prevention-it is never too early to start. J Med Life. 2019;12(4):332-7. [Crossref]  [PubMed]  [PMC] 
  18. Austad SN, Ballinger S, Buford TW, Carter CS, Smith DL Jr, Darley-Usmar V, et al. Targeting whole body metabolism and mitochondrial bioenergetics in the drug development for Alzheimer's disease. Acta Pharm Sin B. 2022;12(2):511-31. [Crossref]  [PubMed]  [PMC] 
  19. Arvanitakis Z, Shah RC, Bennett DA. Diagnosis and management of dementia: review. JAMA. 2019;322(16):1589-99. [Crossref]  [PubMed]  [PMC] 
  20. Grande G, Qiu C, Fratiglioni L. Prevention of dementia in an ageing world: evidence and biological rationale. Ageing Res Rev. 2020;64:101045. [Crossref]  [PubMed] 
  21. Tecalco-Cruz AC, Ramírez-Jarquín JO, Alvarez-Sánchez ME, Zepeda-Cervantes J. Epigenetic basis of Alzheimer disease. World J Biol Chem. 2020;11(2):62-75. [Crossref]  [PubMed]  [PMC] 
  22. Więckowska-Gacek A, Mietelska-Porowska A, Wydrych M, Wojda U. Western diet as a trigger of Alzheimer's disease: from metabolic syndrome and systemic inflammation to neuroinflammation and neurodegeneration. Ageing Res Rev. 2021;70:101397. [Crossref]  [PubMed] 
  23. National Institute on Aging [Internet]. [Cited: March 05, 2020]. What Happens to the Brain in Alzheimer's Disease. Available from: [Link] 
  24. Khan S, Barve KH, Kumar MS. Recent advancements in pathogenesis, diagnostics and treatment of Alzheimer's disease. Curr Neuropharmacol. 2020;18(11):1106-25. [Crossref]  [PubMed]  [PMC] 
  25. Lashley T, Schott JM, Weston P, Murray CE, Wellington H, Keshavan A, et al Molecular biomarkers of Alzheimer's disease: progress and prospects. Dis Model Mech. 2018;11(5):dmm031781. [Crossref]  [PubMed]  [PMC] 
  26. Khan MSH, Hegde V. Obesity and diabetes mediated chronic inflammation: a potential biomarker in Alzheimer's disease. J Pers Med. 2020;10(2):42. [Crossref]  [PubMed]  [PMC] 
  27. Kwon HS, Koh SH. Neuroinflammation in neurodegenerative disorders: the roles of microglia and astrocytes. Transl Neurodegener. 2020;9(1):42. [Crossref]  [PubMed]  [PMC] 
  28. Hara Y, McKeehan N, Fillit HM. Translating the biology of aging into novel therapeutics for Alzheimer disease. Neurology. 2019;92(2):84-93. [Crossref]  [PubMed]  [PMC] 
  29. Newcombe EA, Camats-Perna J, Silva ML, Valmas N, Huat TJ, Medeiros R. Inflammation: the link between comorbidities, genetics, and Alzheimer's disease. J Neuroinflammation. 2018;15(1):276. [Crossref]  [PubMed]  [PMC] 
  30. Mahan LK, Raymond JL, eds. Akbulut G, çeviri editörü. Krause Besin ve Beslenme Bakım Süreci. 14. Baskı. Ankara: Nobel Tıp Kitabevi; 2019. p.586.
  31. Michailidis M, Moraitou D, Tata DA, Kalinderi K, Papamitsou T, Papaliagkas V. Alzheimer's disease as type 3 diabetes: common pathophysiological mechanisms between Alzheimer's disease and type 2 diabetes. Int J Mol Sci. 2022;23(5):2687. [Crossref]  [PubMed]  [PMC] 
  32. Potenza MA, Sgarra L, Desantis V, Nacci C, Montagnani M. Diabetes and Alzheimer's disease: might mitochondrial dysfunction help deciphering the common path? Antioxidants (Basel). 2021;10(8):1257. [Crossref]  [PubMed]  [PMC] 
  33. Sánchez-Sarasúa S, Fernández-Pérez I, Espinosa-Fernández V, Sánchez-Pérez AM, Ledesma JC. Can we treat neuroinflammation in Alzheimer's disease? Int J Mol Sci. 2020;21(22):8751. [Crossref]  [PubMed]  [PMC] 
  34. Flannery PJ, Trushina E. Mitochondrial dynamics and transport in Alzheimer's disease. Mol Cell Neurosci. 2019;98:109-20. [Crossref]  [PubMed]  [PMC] 
  35. Rigotto G, Basso E. Mitochondrial dysfunctions: a thread sewing together Alzheimer's disease, diabetes, and obesity. Oxid Med Cell Longev. 2019;2019:7210892. [Crossref]  [PubMed]  [PMC] 
  36. Hamzé R, Delangre E, Tolu S, Moreau M, Janel N, Bailbé D, et al. Type 2 diabetes mellitus and Alzheimer's disease: shared molecular mechanisms and potential common therapeutic targets. Int J Mol Sci. 2022;23(23):15287. [Crossref]  [PubMed]  [PMC] 
  37. Tyagi A, Pugazhenthi S. Targeting insulin resistance to treat cognitive dysfunction. Mol Neurobiol. 2021;58(6):2672-91. [Crossref]  [PubMed]  [PMC] 
  38. Agrawal R, Reno CM, Sharma S, Christensen C, Huang Y, Fisher SJ. Insulin action in the brain regulates both central and peripheral functions. Am J Physiol Endocrinol Metab. 2021;321(1):E156-63. [PubMed]  [PMC] 
  39. Berlanga-Acosta J, Guillén-Nieto G, Rodríguez-Rodríguez N, Bringas-Vega ML, García-Del-Barco-Herrera D, Berlanga-Saez JO, et al. Insulin resistance at the crossroad of Alzheimer disease pathology: a review. Front Endocrinol (Lausanne). 2020;11:560375. [Crossref]  [PubMed]  [PMC] 
  40. Arnold SE, Arvanitakis Z, Macauley-Rambach SL, Koenig AM, Wang HY, Ahima RS, et al. Brain insulin resistance in type 2 diabetes and Alzheimer disease: concepts and conundrums. Nat Rev Neurol. 2018;14(3):168-81. [Crossref]  [PubMed]  [PMC] 
  41. Barone E, Di Domenico F, Perluigi M, Butterfield DA. The interplay among oxidative stress, brain insulin resistance and AMPK dysfunction contribute to neurodegeneration in type 2 diabetes and Alzheimer disease. Free Radic Biol Med. 2021;176:16-33. [Crossref]  [PubMed]  [PMC] 
  42. Madhusudhanan J, Suresh G, Devanathan V. Neurodegeneration in type 2 diabetes: Alzheimer's as a case study. Brain Behav. 2020;10(5):e01577. [Crossref]  [PubMed]  [PMC] 
  43. Ferrario CR, Reagan LP. Insulin-mediated synaptic plasticity in the CNS: Anatomical, functional and temporal contexts. Neuropharmacology. 2018;136(Pt B):182-91. [Crossref]  [PubMed]  [PMC] 
  44. Kubis-Kubiak AM, Rorbach-Dolata A, Piwowar A. Crucial players in Alzheimer's disease and diabetes mellitus: Friends or foes? Mech Ageing Dev. 2019;181:7-21. [Crossref]  [PubMed] 
  45. Ramírez-Expósito MJ, Martínez-Martos JM, Cantón-Habas V, Del Pilar Carrera-González M. Putative Involvement of endocrine disruptors in the Alzheimer's disease via the ınsulin-regulated aminopeptidase/GLUT4 pathway. Curr Neuropharmacol. 2021;19(7):939-56. [Crossref]  [PubMed]  [PMC] 
  46. McNay EC, Pearson-Leary J. GluT4: a central player in hippocampal memory and brain insulin resistance. Exp Neurol. 2020;323:113076. [Crossref]  [PubMed]  [PMC] 
  47. Lee HJ, Seo HI, Cha HY, Yang YJ, Kwon SH, Yang SJ. Diabetes and Alzheimer's disease: mechanisms and nutritional aspects. Clin Nutr Res. 2018;7(4):229-40. [Crossref]  [PubMed]  [PMC] 
  48. Pruzin JJ, Nelson PT, Abner EL, Arvanitakis Z. Review: relationship of type 2 diabetes to human brain pathology. Neuropathol Appl Neurobiol. 2018;44(4):347-62. [Crossref]  [PubMed]  [PMC] 
  49. Khan MS, Ikram M, Park TJ, Kim MO. Pathology, risk factors, and oxidative damage related to type 2 diabetes-mediated Alzheimer's disease and the rescuing effects of the potent antioxidant anthocyanin. Oxid Med Cell Longev. 2021;2021:4051207. [Crossref]  [PubMed]  [PMC] 
  50. Jayaraj RL, Azimullah S, Beiram R. Diabetes as a risk factor for Alzheimer's disease in the Middle East and its shared pathological mediators. Saudi J Biol Sci. 2020;27(2):736-50. [Crossref]  [PubMed]  [PMC] 
  51. Sun Y, Ma C, Sun H, Wang H, Peng W, Zhou Z, et al. Metabolism: a novel shared link between diabetes mellitus and Alzheimer's disease. J Diabetes Res. 2020;2020:4981814. [Crossref]  [PubMed]  [PMC] 
  52. Guo T, Zhang D, Zeng Y, Huang TY, Xu H, Zhao Y. Molecular and cellular mechanisms underlying the pathogenesis of Alzheimer's disease. Mol Neurodegener. 2020;15(1):40. [Crossref]  [PubMed]  [PMC] 
  53. Hashioka S, Wu Z, Klegeris A. Glia-driven neuroinflammation and systemic inflammation in Alzheimer's disease. Curr Neuropharmacol. 2021;19(7):908-24. [Crossref]  [PubMed]  [PMC] 
  54. Tumminia A, Vinciguerra F, Parisi M, Frittitta L. Type 2 diabetes mellitus and Alzheimer's disease: role of insulin signalling and therapeutic implications. Int J Mol Sci. 2018;19(11):3306. [Crossref]  [PubMed]  [PMC] 
  55. Calabrò M, Rinaldi C, Santoro G, Crisafulli C. The biological pathways of Alzheimer disease: a review. AIMS Neurosci. 2020;8(1):86-132. [Crossref]  [PubMed]  [PMC] 
  56. Pugazhenthi S, Qin L, Reddy PH. Common neurodegenerative pathways in obesity, diabetes, and Alzheimer's disease. Biochim Biophys Acta Mol Basis Dis. 2017;1863(5):1037-45. [Crossref]  [PubMed]  [PMC] 
  57. Sędzikowska A, Szablewski L. Insulin and insulin resistance in Alzheimer's disease. Int J Mol Sci. 2021;22(18):9987. [Crossref]  [PubMed]  [PMC] 
  58. Williamson CB, Pizano JM. Kronik hastalık üzerindeki epigenetik etkilere beslenme genetiği yaklaşımı. Kalamian M. Terapötik ketojenik diyet: glukoz, insülin ve keton metabolizmasından faydalanma. Noland D, Drisko JA, Wagner L, editörler. Bütüncül ve Fonksiyonel Tıp Nutrisyonel Tedavi-İlkeler ve Tedaviler. 1. Baskı. İstanbul: Celsus Kitabevi; 2021. p.240-347.
  59. Nguyen TT, Ta QTH, Nguyen TKO, Nguyen TTD, Giau VV. Type 3 diabetes and its role implications in Alzheimer's disease. Int J Mol Sci. 2020;21(9):3165. [Crossref]  [PubMed]  [PMC] 
  60. Marseglia A, Fratiglioni L, Kalpouzos G, Wang R, Bäckman L, Xu W. Prediabetes and diabetes accelerate cognitive decline and predict microvascular lesions: a population-based cohort study. Alzheimers Dement. 2019;15(1):25-33. [Crossref]  [PubMed] 
  61. Schneider ALC, Selvin E, Sharrett AR, Griswold M, Coresh J, Jack CR Jr, et al. Diabetes, prediabetes, and brain volumes and subclinical cerebrovascular disease on MRI: the atherosclerosis risk in communities neurocognitive study (ARIC-NCS). Diabetes Care. 2017;40(11):1514-21. [Crossref]  [PubMed]  [PMC] 
  62. An Y, Varma VR, Varma S, Casanova R, Dammer E, Pletnikova O, et al. Evidence for brain glucose dysregulation in Alzheimer's disease. Alzheimers Dement. 2018;14(3):318-29. [Crossref]  [PubMed]  [PMC] 
  63. Lewitt MS, Boyd GW. The role of insulin-like growth factors and insulin-like growth factor-binding proteins in the nervous system. Biochem Insights. 2019;12:1178626419842176. [Crossref]  [PubMed]  [PMC] 
  64. Zheng J, Xu M, Walker V, Yuan J, Korologou-Linden R, Robinson J, et al. Evaluating the efficacy and mechanism of metformin targets on reducing Alzheimer's disease risk in the general population: a Mendelian randomisation study. Diabetologia. 2022;65(10):1664-75. [Crossref]  [PubMed]  [PMC] 
  65. Chapman CD, Schiöth HB, Grillo CA, Benedict C. Intranasal insulin in Alzheimer's disease: food for thought. Neuropharmacology. 2018;136(Pt B):196-201. [Crossref]  [PubMed] 

.: Up To Date

.: Process List

Login

 Forgot your password?

 New Registration  

Contact

Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com