10 ways whose diabetes and dementia are shockingly connected

Diabetes affects the brain through energy consumption, blood vessels and inflammation. Some treatments can slow down or prevent dementia.

The link between diabetes and dementia regularly becomes more obvious. Recent studies highlight how disruption of blood sugar regulation can alter brain function, while brain disorders can, in turn, affect glucose control. You will find below ten results based on research which explain how the two conditions are linked.

1) Diabetes increases the risk of dementia

People with diabetes face approximately 60% of dementia of dementia in relation to those without illness. Repeated episodes of low blood sugar are also associated with a probability of cognitive decline of 50% higher.

2) Insulin resistance also affects the brain

Insulin resistance – The main engine of type 2 diabetes – occurs when cells do not respond appropriately insulin. Consequently, excess glucose remains in the blood circulation, resulting in harmful consequences.

Although this resistance is most often observed in the liver and muscles, it also occurs in the brain. In Alzheimer’s The disease, this reduced to insulin response can limit brain capacity to use glucose for fuel, contributing to the loss of cognitive capacity.

3) a shortage of brain sugar in dementia

Although the brain represents only 2% of the total body weight, it consumes approximately 20% of the body’s energy. In dementia, nerve cells seem to lose the ability to effectively use glucose.

This combination of altered use of glucose and insulin resistance has sometimes been informally called type 3 diabetes.

4) Alzheimer’s disease can increase the risk of diabetes

People with Alzheimer’s often have higher fasting blood sugar, even if they do not have diabetes. This is a form of pre-diabetes. Animal studies also show that Alzheimer’s changes in the brain increase blood sugar.

In addition, the highest genetic genetic risk factor in Alzheimer’s, the genetic variant of APOE4, reduces insulin sensitivity by trapping insulin receptor inside the cell, where it cannot be activated correctly.

5) The damage caused by blood vessels links the two conditions

Diabetes damages the blood vessels, causing complications in the eyes, kidneys and hearts. The brain is also at risk. High or variable blood sugar levels can hurt the vessels in the brain, reducing blood circulation and oxygen administration.

Diabetes can also weaken the protective barrier of the brain, letting harmful substances enter. This leads to inflammation. Reduction of blood flow and brain inflammation are strongly linked to dementia.

6) Memantine: a dementia medication born from research on diabetes

Memantine, used to treat moderate to severe Alzheimer’s symptoms, has been initially developed as diabetes medication. He failed to control blood sugar, but the researchers later discovered his advantages for the brain function. This story shows how diabetes research can have indications for treating brain disorders.

7) Metformin could protect the brain

Metformin, the most used diabetes medication, is more than lowered blood sugar. It enters the brain and can reduce brain inflammation.

Some studies suggest that people with diabetes who take metformin are less likely to develop dementia, and those who cease to take it can review their risk increasing.

The trials test its effects in people without diabetes.

8) Weight loss injections can reduce the accumulation of plaque

GLP-1 receptive agonist drugs, such as semaglutide (Ozempique, Wegovy), the drop in blood sugar and support weight loss. The files show that people with diabetes on these drugs have a lower risk of dementia. By comparing GLP1 drugs to metformin, studies have shown that they were even more effective than metformin to reduce the risk of dementia.

Two major trials, Evoke and Evoke Plus, test the oral semaglutide in people with light cognitive impairment or early alzheimer.

9) Insulin therapy could help the brain

Since insulin resistance in the brain is a problem, researchers have tested insulin sprays given by the nose. This method provides insulin directly to the brain while reducing the effects on blood sugar.

Small studies suggest that these sprays can help memory or reduce brain narrowing, but delivery methods remain a challenge. Pulverizations vary in the amount of insulin reaches the brain, and long -term security has not yet been proven.

10) SGLT2 inhibitors can reduce the risk of dementia

New evidence suggests that compared to GLP-1 receptors, SGLT2 inhibitors (a type of diabetes drug) are greater than the risk of dementia, including Alzheimer’s and vascular dementia, in people with type 2. These tablets are lowering blood sugar by increasing sugar in the urine. This study is based on early evidence suggesting that they reduce the risk of dementia by reducing inflammation in the brain.

This growing corpus of evidence suggests that the management of diabetes protects more than the heart and the kidneys, it also helps to preserve the functioning of the brain.

Questions remain, whether diabetes drugs only reduce the risk of dementia associated with diabetes or if these drugs could also reduce risk in diabetes without diabetes.

However, research on diabetes was very successful in creating at least 13 different classes of drugs, several combined therapies, giving birth to at least 50 different drugs. These reduce blood sugar, improve insulin sensitivity and reduce inflammation. A “side effect” can be a better preservation of brain health during aging.

Written by:

• Craig Beall, associate professor in experimental diabetes, University of Exeter
• Natasha Macdonald, Doctorate, Biochemistry, University of Exeter

Adapted from an article initially published in the conversation.

Craig Beall is currently receiving Diabetes UK funds, Breakthrough T1D, Steve Morgan Foundation Type 1 Diabetes Grand Challenge, Medical Research Council, NC3RS, Society for Endocrinology and British Society for Neuroendocrinology.

Natasha Macdonald receives financing for UK diabetes.

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