The incidence of Type Two diabetes is escalating dramatically across the world. It has been described as being at pandemic proportions. There are over 310 million people around the world with diabetes and over one million Australians. Worse still is the realisation that perhaps 500,000 Australians are completely unaware they have the condition.
275 Australians are being diagnosed with Type Two diabetes every day.
By 2025 the number of Australians with diabetes is expected to reach 3 million.
Type Two diabetes accounts for 90% of all diabetes and is associated with insulin resistance.
Why is this such a concern?
Diabetes is a significant risk factor for dementia.
When you think about diabetes, what do you envisage this means for the person with the disease? Lots of pin-prick blood tests, a diet, perhaps medication or insulin injections?
You may be aware that diabetes affects multiple organs in the body and is associated with an increased risk of heart disease, kidney disease and vascular disease.
But perhaps up until now the realisation of the link between diabetes and dementia hasn't struck home.
But it needs to.
According to a new study published in Neurology, diabetes isn't just linked to Alzheimer's disease, (the commonest form of dementia) it's also linked to vascular dementia where damage to blood vessels leads to cerebral injury as "mini-strokes" or TIA's and silent infarcts where brain cell death occurs.
And many other people are also at risk. They have what is known as "Preclinical diabetes" where they have not developed the full condition of diabetes, but have evidence of impaired glucose tolerance.
It was Barnes and Yaffe who in 2011 identified the top seven potentially modifiable risk factors, which if addressed could hopefully see a reduction in the estimated numbers of people being diagnosed with Alzheimer's disease. Diabetes is in the top seven.
If you have diabetes it is crucial that you maintain good blood sugar control to minimise your own future risk. If you have pre-clinical diabetes the same applies.
The good news is that modifying your risk is achievable through lifestyle choices, which can impact the likelihood of dementia occurring.
- Keep tight blood sugar control.
- Keep your weight in the healthy range. Losing weight reduces your risk of developing diabetes in the first place by 40%.
- Choose healthy foods that nourish your body and brain based on the Mediterranean diet. Look to add green leafy vegetables, fruit, seeds, nuts, lean protein and wholegrains at every meal.
- Move. Living a sedentary lifestyle increases your risk of premature death and dementia. Just getting started with walking a couple of 30 minute walks three times a week can halve your risk of Alzheimer's and reduce your risk of stroke by over 60%.
So just to reinforce the message:
A person with diabetes has twice the risk of developing dementia compared to a person with normal blood sugar levels.
And this risk is the same even taking into consideration other risk factors such as high blood pressure, high cholesterol and smoking.
I often get asked what a person can do to minimise their risk of Alzheimer's, especially if they have a family history. Whilst genes matter, how and when they are expressed will be influenced by how we choose to live.
So if you want to choose life without dementia, choose to avoid diabetes, or if you already have it, look to optimise your blood sugar control.
Your brain depends on it.
T. Ohara, Y. Doi, T. Ninomiya, Y. Hirakawa, J. Hata, T. Iwaki, S. Kanba, Y. Kiyohara. Glucose tolerance status and risk of dementia in the community: The Hisayama Study. Neurology, 2011; 77 (12): 1126 DOI: 10.1212/WNL.0b013e31822f0435
Weili Xu, et al. Mid- and Late-Life Diabetes in Relation to the Risk of Dementia. Diabetes, January 2009
Rachel A. Whitmer, PhD; Andrew J. Karter, PhD; Kristine Yaffe, MD; Charles P. Quesenberry Jr, PhD; Joseph V. Selby, MD. Hypoglycemic Episodes and Risk of Dementia in Older Patients With Type 2 Diabetes Mellitus. JAMA, 2009;301(15):1565-1572 [link]
Barnes DE, Yaffe K. (2011) The projected effect of risk factor reduction on Alzheimer’s disease prevalence. Lancet Neurol. Jul 18;
Sonnen et al. Different Patterns of Cerebral Injury in Dementia With or Without Diabetes. Arch Neurol, 2009; 66 (3) DOI: 10.1001/archneurol.2008.579