Could type 2 diabetes lead to Alzheimers? Views on this matter are mixed as research continues.

According to an April 3, 2013 article on Mayoclinic.com, people with diabetes, particularly type 2 diabetes, have a greater chance of having dementia including Alzheimer's disease. Conversely, managing or avoiding diabetes may also protect you from Alzheimers.

It is known that type 2 diabetes causes damage to the brain and body relative to sugar and the insulin response. Mild cognitive dysfunction can also be a result of type 2 diabetes. Is this a path to Alzheimer's disease?

Dr. Sam Gandy, M.D., Ph.D., said on the Alzheimer’s Association website that diabetes increases the risk Alzheimer’s disease.

Gandy is Mount Sinai Chair in Alzheimer’s Disease Research Director, Mount Sinai Center for Cognitive Health and NFL Neurological Care Professor of Neurology and Psychiatry (Dual Primary Appointments) Associate Director, and Mount Sinai Alzheimer’s Disease Research Center Mount Sinai School of Medicine.

Gandy described one model researchers are considering where both Alzheimer’s disease and diabetes involve unchecked inflammation.

Fat deposits and blood vessels are affected by inflammation in diabetes. The brain experiences inflammation in Alzheimers. Researchers are investigating to see whether or not Alzheimers can be detected through C-reactive protein (CRP) levels, which estimate the amount of inflammation in the brain and the body.

Mark Bittman wrote on Diabetes.org that Alzheimers may be a kind of diabetes brought on by a poor diet. Diabetes causes damage related to insulin resistance. When brain cells are affected, cognitive dysfunction which may be dementia, can result.

Insulin resistance, or a lack of insulin, can affect mental function, and may also be involved in creating beta amyloid plaques, abnormal proteins that replace normal brain cells.

According to Bittman, some researchers have conflicting views about whether or not Alzheimers should be considered type 3 diabetes or diabetes of the brain. Some of those who think so come to this conclusion because Alzheimers is linked with low insulin levels in the brain.

The standard North American diet is resulting in greater numbers of people with type 2 diabetes along with more people struggling with obesity. Diabetics have twice the risk, or more, of developing Alzheimers. Obesity also raises the dangers of brain dysfunction.

It may be that diabetes does not cause Alzheimers, but they may have the same cause, according to Suzanne de la Monte, a neuropathologist at Brown University. Eating too many foods that impair insulin function are the basis for both conditions.

Other factors include genetic predisposition, meaning some people are more prone to the potential of either or both conditions.

Research at Mount Sinai and Columbia may show that some defective genes boost the risk of insulin resistance and brain amyloid beta 42 buildup. People with the APOE4 gene who don't exercise are prone to having more brain amyloid, and a greater risk for Alzheimers.

The upside is that eating a healthy diet can reduce the risk for diabetes, and perhaps for Alzheimers.

A study funded by the National Institute of Diabetes and Digestive and Kidney Diseases indicated that when people have blood sugar levels that are only slightly higher than normal (prediabetic levels) this can reduce their risk for type 2 diabetes by more than 50 percent.

The study indicated that losing only 5-7 percent of their body weight, and doing half an hour of exercise five times a week can lower the risk for type 2 diabetes.

Fortunately, there are ways of reducing your risk for both diabetes and Alzheimers.

The Mayo Clinic website recommends a wholesome diet, regular exercise and maintaining a healthy weight to lessen the risk for diabetes, and hence for dementia. Brushing and flossing every day can also be beneficial.

The Alzheimer's Association website said that gastric bypass for the extremely obese may be one way of regulating insulin function. Thirty minutes of exercise including resistance training like weightlifting or walking vigorously three times a week can slow Alzheimers progression.

The effects of APOE4 on the buildup of brain amyloid can be decreased or even eliminated by physical exercise or social activity, both of which have been determined to work better than drugs.

Sources:

Diabetes and Alzheimer's linked. Mayoclinic.com. Retrieved Nov. 10, 2013.
http://www.mayoclinic.com/health/diabetes-and-alzheimers/AZ00050
http://www.mayoclinic.com/health/diabetes-and-alzheimers/AZ00050/NSECTIO...

Why Does Diabetes Increase the Risk for Alzheimer’s Disease? And What Can I Do to Reduce My Risk?. ALZNYC.org. Retrieved Nov. 10, 2013.
http://www.alznyc.org/nyc/newsletter/fall2012/02.asp#.UoAshnB9AU0

Is Alzheimer’s Type 3 Diabetes? Diabetes.org. Retrieved Nov. 10, 2013.
http://community.diabetes.org/t5/Discuss-Diabetes-News/Is-Alzheimer-s-Ty...

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Reviewed November 12, 2013
by Michele Blacksberg RN