Alzheimer’s :: Is It Really Type 3 Diabetes?

Alzheimer’s :: Is It Really Type 3 Diabetes?

Alzheimer’s and diabetes: What’s the link? Is there even a link?

You may have heard that Alzheimer’s Disease is recently being touted as “type 3 diabetes.” In fact, this link was first suggested way back in 1989, but is just starting to get traction and buzz now. So, I wanted to find out, is it just sensational headlines? Or is there some actual science behind it?

Specifically, I wanted to dig into the research to give you the goods on whether Alzheimer’s represents the evolution of diabetes to that of a brain disease: “type 3 diabetes.”

But, before we dive into the concept of “type 3” diabetes, let’s get a super-quick primer on blood sugar regulation, and types 1 and 2 diabetes.

BLOOD SUGAR REGULATION 101

Your body needs to regulate so many aspects of your blood for optimal health. Blood sugar level is just one of them. When blood sugar levels get too low or too high for too long, you can end up with diabetes.

When you eat or drink your blood sugar goes up. This is your digestive system doing its job to absorb nutrients from your food. And this is normal and healthy.

FUN FACTOID: Blood sugar increases are mostly from eating carbs, and fats/proteins can reduce blood sugar increases caused by carbs. So eat some healthy fat or protein with carbs!

When your blood sugar level increases, your body takes that sugar from your blood to use it as energy in your cells or store it for later use. It does this with the hormone “insulin.”

When your blood sugar level increases, your body takes that sugar from your blood to use it as energy in your cells or store it for later use. It does this with the hormone “insulin.” Insulin tells your cells to take the sugar out of your blood.

This system can go wrong in a few different ways.

Enter diabetes...

DIABETES

There are many different blood-sugar regulation issues, the most serious is diabetes. Diabetes occurs when the body isn’t managing blood sugar levels properly any more. When the blood sugar gets too high, insulin injections may be needed to bring blood sugar down. When the blood sugar gets too low, a sugary food or drink may be needed to bring blood sugar back up. And many people are on daily medications to prevent these extremes.

Type 1 diabetes mellitus (T1DM) is most commonly first diagnosed in younger people. It occurs when the immune system attacks the insulin-producing cells in the pancreas. When these cells are injured and die, they cannot make enough insulin. In this case, blood sugar levels can get too high for too long because of lack of insulin.

Type 2 diabetes mellitus (T2DM) is about 10x more common than T1DM. It’s often related to obesity and inflammation. It used to be called “adult-onset” diabetes, but many children are being diagnosed with it now.

The last super-quick primer I want to mention is “insulin resistance.” It often precedes T2DM and is referred to as “pre-diabetes.” This is when blood sugar and insulin levels are too high too often, and the cells are so used to having insulin knocking on their door telling them to remove sugar from the blood, that they start to ignore it. They resist it. So the sugar stays in the blood and the pancreas keeps sending out more insulin (as long as it still can). There ends up being a vicious cycle of high blood sugar and high insulin. Until, eventually, those insulin-producing cells in the pancreas wear out, and the result is diabetes.

So, what the heck is type 3 diabetes?

And what does this have to do with your brain?

In the last 15 years, we’ve discovered that insulin has several roles in the brain! And when the brain gets insulin deficient or becomes insulin resistant...that can lead to impaired cognition (ability to think), memory loss, and even neuro-degeneration (break down of nerve cells).

In the last 15 years, we’ve discovered that insulin has several roles in the brain! And when the brain gets insulin deficient or becomes insulin resistant...that can lead to impaired cognition (ability to think), memory loss, and even neuro-degeneration (break down of nerve cells).

HOW ARE ALZHEIMER’S AND DIABETES CONNECTED?

Alzheimer’s disease is the most common form of dementia, and there are many links between Alzheimer’s disease (AD) and diabetes. For example, both diseases display insulin resistance, chronic inflammation, increased oxidative stress, and impaired cognition (to name some of the biggest commonalities the research shows and that I’ve seen).

People with type 2 diabetes (T2DM) have up to 2x the risk of developing AD than people without it. And, some studies show that older people with T2DM have more brain atrophy (reduced brain size) than older people without T2DM.

Also, importantly, people with type 2 diabetes (T2DM) have up to 2x the risk of developing AD than people without it. And, some studies show that older people with T2DM have more brain atrophy (reduced brain size) than older people without T2DM. Of relevance to note: This brain atrophy is eerily similar to that seen in people with AD. One study has even concluded that 10% of world-wide cases of dementia may be a direct result from T2DM. Woah!

And — it goes both ways. People with AD have a higher risk of developing T2DM. In fact, according to the Mayo Clinic Alzheimer Disease Patient Registry, 80% of AD patients have diabetes or other blood sugar issues.

THE CONNECTION: BLOOD SUGAR & YOUR BRAIN

Insulin in the brain helps to regulate appetite, blood sugar and blood fat levels, and it also help with memory, learning, and is neuroprotective (it protects your brain cells). When blood sugar and insulin levels around the brain aren’t regulated, it can initiate or worsen AD. In fact, some people with insulin resistance have memory issues even before being diagnosed with T2DM. And some diabetes medications have resulted in improved cognition in people with AD. Woah again. This is so interesting for me to ponder, given how much good we can do for diabetes with food and supplements. Maybe we could help AD with the same NeuroT Rx!

Recent studies also show that insulin in the brain can reduce the formation of dangerous AD-related brain structural issues like “neurofibrillary tangles” and “amyloid-β plaques" (Aβ; the characteristic, diagnostic feature of AD).

But, it’s not just about blood sugar and insulin resistance. There’s also the inflammation and oxidative stress that go hand-in-hand with insulin resistance, obesity, T2DM, and the amyloid-β plaques.

So, you can see there sure are a lot of interconnections between T2DM and AD. But, is it legit to say Alzheimer’s disease is type 3 diabetes (T3DM)?

IS ALZHEIMER’S REALLY TYPE 3 DIABETES?

Overall, as I’ve outlined there are a bunch of factors that tie Alzheimer’s with diabetes. I mean, having one increases your risk of getting the other. T2DM causes brain insulin resistance and some features of AD. That along with inflammation, oxidative stress, and other factors are found in both of these chronic diseases.

More and more research over the last few decades is showing several strong links between insulin resistance/diabetes and cognitive impairment/Alzheimer’s disease.

According to the scientific literature aging, not T2DM, is still the strongest risk factor for AD. And researchers don’t yet know exactly how much T2DM contributes to the onset of AD. But more and more research over the last few decades is showing several strong links between insulin resistance/diabetes and cognitive impairment/Alzheimer’s disease. As they say, there is a “significant association.” Which means I’m eagerly listening.

Many researchers now even agree that there is enough overlap between the two conditions that AD, is in fact, a form of diabetes that affects the brain. And if this is the case, I feel really hopeful that the NeuroTrition Rx, which has blood sugar balancing at its foundational core, can help those with or at risk of AD.

KEY TAKEAWAYS

Both T2DM and AD are chronic diseases that impact health. Check.

They share a number of common characteristics including blood sugar and insulin issues, inflammation and oxidative stress, and cognitive impairment. Check.

The main treatments for both T2DM and AD help to manage or slow progression of symptoms, but don’t cure the conditions. Okay.

So what is the take-away, based on this data, to address “type 3 diabetes?”

The main point for you to ponder is that blood sugar DOES affect your brain (if you’ve ever felt HANGRY, or taken a ride on the FOOD SWING, you know how much it does). And, given where the science is going, I have reason to believe that blood sugar imbalances are a significant risk factor for developing Alzheimer’s. Given this, then, it is so important for you to work on balancing your blood sugar to not only ward off or manage diabetes, but to also reduce your risk of developing Alzheimer’s disease. When I am working with a client to get them off the blood sugar rollercoaster we always work on the following:

  1. Eating breakfast within an hour of waking up to “break the fast”
  2. Eating something every 3 hours to keep blood sugar in a stable zone
  3. Making sure to have a mid-afternoon snack to prevent the crash
  4. Always eating carbs with a healthy fat and/or protein to reduce carbs’ impact
  5. Moving (even gentle walking and other mild activity can help)

These tips form the core of any NeuroTrition Rx we prescribe, and can begin working in as little as 48 hours. For specific Alzheimer’s diet recommendations, we’ve got a blog reviewing two diets that science tells us can help prevent AD. Check it out, here.

References

Biessels, G.J., Strachan, M.W.J., Visseren, F.L.J., Kappelle, L.J., & Whitmer, R.A. (2014). Dementia and cognitive decline in type 2 diabetes and prediabetic stages: towards targeted interventions. The Lancet Diabetes & Endocrinology. 2(3), 246–255.

De la Monte, S. M., & Wands, J. R. (2008). Alzheimer’s Disease Is Type 3 Diabetes–Evidence Reviewed. Journal of Diabetes Science and Technology (Online). 2(6), 1101–1113.

González-Reyes, R.E., Aliev, G., Ávila-Rodrigues, M., & Barreto, G.E. (2016). Alterations in Glucose Metabolism on Cognition: A Possible Link Between Diabetes and Dementia. Current Pharmaceutical Design. 22(7), 812-8.

Heni, M., Kullmann, S., Preissl, H., Fritsche, A. & Häring, H.U. (2015). Impaired insulin action in the human brain: causes and metabolic consequences. Nature Reviews Endocrinology. 11(12), 701-11.

Hoyer S., & Nitsch R. (1989). Cerebral excess release of neurotransmitter amino acids subsequent to reduced cerebral glucose metabolism in early-onset dementia of Alzheimer type. Journal of Neural Transmission. 75(3), 227–232.

Kandimalla, R., Thirumala, V., & Reddy, P.H. (2017). Is Alzheimer's disease a Type 3 Diabetes? A critical appraisal. Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease. 1863(5), 1078-1089.

Kang, S., Lee, Y.H., & Lee, J.E. (2017). Metabolism-Centric Overview of the Pathogenesis of Alzheimer's Disease. Yonsei Medical Journal. 58(3), 479-488.

Kooistra M., Geerlings M. I., Mali W. P. T. M., Vincken K. L., Van Der Graaf Y., Biessels G. J. (2013). Diabetes mellitus and progression of vascular brain lesions and brain atrophy in patients with symptomatic atherosclerotic disease. the SMART-MR study. Journal of the Neurological Sciences. 332(1-2), 69–74.

Mittal, K., & Katare, D,P. (2016). Shared links between type 2 diabetes mellitus and Alzheimer's disease: A review. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 10(2 Suppl 1), S144-9.

Moran C., Phan T. G., Chen J., et al. (2013). Brain atrophy in type 2 diabetes: regional distribution and influence on cognition. Diabetes Care. 36(12), 4036–4042.

Verdile, G., Keane, K.N., Cruzat, V.F., Medic, S., Sabale, M., Rowles, J., Wijesekara, N., Martins, R.N., Fraser, P.E., & Newsholme, P. (2015). Inflammation and Oxidative Stress: The Molecular Connectivity between Insulin Resistance, Obesity, and Alzheimer’s Disease. Mediators of Inflammation, 105828.

Walker, J.M., & Harrison, F.E. (2015). Shared Neuropathological Characteristics of Obesity, Type 2 Diabetes and Alzheimer’s Disease: Impacts on Cognitive Decline. Nutrients. 7(9), 7332–7357.

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