It may be hard to imagine a connection between type 2 diabetes and Alzheimer’s disease or other forms of degenerative brain disease. But it’s real—and it’s so strong that many experts are now referring to it as type 3 diabetes or brain diabetes. By any name, it’s the progression from type 2 diabetes to Alzheimer’s disease marked with severe memory loss, a massive downgrade in quality of life and a dramatic decline in cognitive function.
Did you know, 2 out of 3 Americans are projected to suffer from type 2 diabetes by 2030? People with diabetes have a 60 percent increased risk of developing dementia, recent research suggests that women with type 2 diabetes have a 19 percent greater risk of a certain type, known as vascular dementia (which is caused by problems with blood supply to the brain) than men do.
Overall, adults with type 2 diabetes suffer from greater declines in working memory and executive functioning (a set of mental processes that involve planning, organization, controlling attention, and flexible thinking) than their peers do.
Granted, not everyone who has type 2 diabetes will develop Alzheimer’s disease or any other form of dementia, and there are many people who have Alzheimer’s who don’t have diabetes. However, the reality is, “these risk factors tend to add up: If you have diabetes, that doubles the risk of developing Alzheimer’s. And if you have poorly controlled blood pressure, excess abdominal fat, or sleep apnea, your risk of developing a degenerative brain disease is increased even more.
As far as how type 2 diabetes increases the risk of Alzheimer’s—well, it’s complicated. For starters, high blood sugar leads to inflammation throughout your body and brain. With respect to Alzheimer’s, this is a problem because chronic inflammation has been linked with the formation of amyloid plaques and tau tangles, abnormalities in the brain that are hallmarks of Alzheimer’s disease.
In addition, insulin resistance (the hallmark of type 2 diabetes) can impair blood flow to the brain, which means brain cells aren’t getting sufficient oxygen and nutrients for them to function properly. And then there’s the added problem of insulin insensitivity in the brain—simply put, just as insulin resistance plays out in the rest of the body, when there’s impaired insulin signaling in the brain, brain cells can’t use glucose (their primary energy source) properly, and brain function suffers as a result. In case that isn’t worrisome enough, “when circulation to the brain is compromised, you’re more prone to developing small strokes [that can increase the risk of dementia],” notes Gary Small, M.D., a professor of psychiatry at the UCLA Semel Institute and author of The Alzheimer’s Prevention Program.
Meanwhile, type 2 diabetes can cause toxic proteins to accumulate in the brain and it may impair the brain’s ability to clear out waste products, too, explains Suzanne Craft, Ph.D., professor of medicine and director of the Alzheimer’s Disease Core Center at the Wake Forest School of Medicine in Winston-Salem, North Carolina. Moreover, “type 2 diabetes may [compromise] … important brain functions such as the formation and maintenance of new connections between brain cells.”
While this all may sound alarming, there’s good news: Half of a person’s risk of developing Alzheimer’s is attributable to factors you can change, such as diet, supplementation and physical activity. Taking steps to control your long term quality of life with lifestyle changes may help reduce your risk of developing cognitive impairment. Here’s how:
The American Diabetes Association recommends doing 30 minutes of moderate-to-vigorous intensity exercise four times per week. Aerobic exercise boosts circulation throughout the body and the brain; helping your body use insulin better.
Gluten and sugar promote inflammation in the brain and the digestive tract. Avoid sugar whenever possible and seek more gluten free options when possible. Certain spices (such as turmeric and cinnamon) and herbs (such as ginger and oregano) have anti-inflammatory and/or blood-sugar-lowering benefits.
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To keep your mind sharp, it’s also wise to get plenty of good quality sleep and to manage stress. It also helps to train your brain with the right forms of stimulation, whether you want to learn a new skill (pottery or cooking, anyone?), read challenging books, or play word games, math games, computer games, or trivia games.
Ultimately, “it’s easier to protect a healthy brain than to try to repair damage once it’s extensive,” Dr. Small says. “And what you do to help your brain also helps your body.” That’s a double payoff, if ever there was one.
Stacey Colino, Disease-Proof: The Remarkable Truth About What Makes Us Well, with Dr. David Katz.
American Diabetes Association, Fitness: “What We Recommend.” http://www.diabetes.org/food-and-fitness/fitness/types-of-activity/what-we-recommend.html Bharadwaj, P., Wijesekara, N., Liyanapathirana, M., et al. “The Link between Type 2 Diabetes and Neurodegeneration: Roles for Amyloid-B, Amylin, and Tau Proteins.” Journal of Alzheimer’s Disease. March 1, 2017. https://www.ncbi.nlm.nih.gov/pubmed/28269785
Chatterjee, S., Peters, S.A.E., Woodward, M., et al. “Type 2 Diabetes as a Risk Factor for Dementia in Women Compared With Men: A Pooled Analysis of 2.3 Million People Comprising More Than 100,000 Cases of Dementia.” Diabetes Care. February 2016; 39(2): 300-307. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4722942/
Leszek, J., Trypka, E., Tarasov, V.V., et al. “Type 3 Diabetes Mellitus: A Novel Implication of Alzheimer Disease.” Current Topics in Medicinal Chemistry. January 3, 2017. https://www.ncbi.nlm.nih.gov/pubmed/28049395
Mittal, K., Mani, R.J., Katare, D.P. “Type 3 Diabetes: Cross Talk between Differentially Regulated Proteins of Type 2 Diabetes Mellitus and Alzheimer’s Disease.” Nature. May 6, 2016. http://www.nature.com/articles/srep25589
Redondo, M.T., Beltran-Brotons, J.L., Reales, J.M., et al. “Executive functions in patients with Alzheimer’s disease, type 2 diabetes mellitus patients and cognitively healthy older adults.” Experimental Gerontology. October 2016: 83: 47-55. https://www.ncbi.nlm.nih.gov/pubmed/27451340