A healthy lifestyle may counteract diabetes-associated brain ageing

From eurekalert.org

Type 2 diabetes and prediabetes are associated with accelerated brain ageing, according to a new study from Karolinska Institutet in Sweden published in the journal Diabetes Care. The good news is that this may be counteracted by a healthy lifestyle.

Type 2 diabetes is a known risk factor for dementia, but it is unclear how diabetes and its early stages, known as prediabetes, affect brain ageing in people without dementia. Now, a comprehensive brain imaging study shows that both diabetes and prediabetes can be linked to accelerated brain ageing.

The study included more than 31,000 people between 40 and 70 years of age from the UK Biobank who had undergone a brain MRI scan (magnetic resonance imaging). The researchers used a machine learning approach to estimate brain age in relation to the person’s chronological age.

Prediabetes and diabetes were associated with brains that were 0.5 and 2.3 years older than chronological age, respectively. In people with poorly controlled diabetes, the brain appeared more than four years older than chronological age. The researchers also noted that the gap between brain age and chronological age increased slightly over time in people with diabetes. These associations were attenuated among people with high physical activity who abstained from smoking and heavy alcohol consumption.

“Having an older-appearing brain for one’s chronological age can indicate deviation from the normal ageing process and may constitute an early warning sign for dementia,” says the study’s lead author Abigail Dove, a PhD student at the Department of Neurobiology, Care Sciences and Society, Karolinska Institutet. “On the positive side, it seems that people with diabetes may be able to influence their brain health through healthy living.”

Repeated MRI data were available for a small proportion of the study participants. Follow-up MRI scans are ongoing and researchers are now continuing to study the association between diabetes and brain ageing over time.

“There’s a high and growing prevalence of type 2 diabetes in the population,” says Abigail Dove. “We hope that our research will help prevent cognitive impairment and dementia in people with diabetes and prediabetes.”

The study was mainly funded by the Swedish Alzheimer’s Foundation, the Dementia Research Fund, the Swedish Research Council and Forte (the Swedish Research Council for Health, Working Life and Welfare). There are no reported conflicts of interest.

Publication: "Diabetes, prediabetes, and brain aging: the role of healthy lifestyle", Abigail Dove, Jiao Wang, Huijie Huang, Michelle M. Dunk, Sakura Sakakibara, Marc Guitart-Masip, Goran Papenberg, Weili Xu, Diabetes Care, online 28 August 2024, doi: 10.2337/dc24-0860 

https://www.eurekalert.org/news-releases/1055727

The Surprising Link Between Diabetes and Dementia

From news.uams.edu

Studies show that having diabetes can increase your risk of dementia. There are several ways that diabetes contributes to dementia. Abnormal blood sugar levels, insulin resistance and other chronic diseases associated with diabetes can damage your brain over time.

• Abnormal blood sugar levels can affect your memory.

Stable blood sugar levels are crucial for clear thinking. However, with diabetes, frequent fluctuations in blood sugar can impair your ability to think clearly. Additionally, both high and low blood sugar levels can damage the blood vessels in your brain, making it difficult for oxygen to reach it. This damage can contribute to the development of dementia.

• Insulin resistance can cause brain cells to break down.

With diabetes, the body’s cells don’t respond as they should to insulin, the hormone that helps your body regulate blood sugar levels. This can lead to problems like inflammation or damage to brain cells, both of which can increase the risk of dementia.

• Health conditions associated with diabetes are also risk factors for dementia.
  Diabetes can lead to health conditions like high blood pressure, heart disease and kidney damage. These chronic diseases can all damage the brain and make dementia more likely.

The good news is that managing your diabetes can lower your chances of developing dementia.

By managing your diabetes with medication and lifestyle choices, you can keep your blood sugar levels stable, improve insulin resistance and help prevent other chronic diseases. Lifestyle choices that can reduce your dementia risk include:

• Getting 2.5 hours of cardio exercise per week, such as brisk walking, dancing or riding your bike
• Eating a balanced diet rich in fruits, vegetables, whole grains, lean proteins and healthy fats
• Keeping your mind active with activities like puzzles or learning new skills
• Staying connected with friends and family
• Getting 7-8 hours of sleep every night

Work closely with your health care team to create a diabetes plan that fits your needs. By effectively managing diabetes and adopting a healthy lifestyle, you can improve your overall health and potentially reduce your risk of dementia.

Sheldon Riklon, M.D., is an associate professor in the University of Arkansas for Medical Sciences (UAMS) Department of Family and Preventive Medicine and a co-investigator with the UAMS Institute for Community Health Innovation.

https://news.uams.edu/2024/05/28/the-surprising-link-between-diabetes-and-dementia/ 

How might diabetes lead to Alzheimer’s? Study suggests liver is key

From asbmb.org

Researchers trace a path from the gut to the brain and say managing diabetes could help to prevent dementia 

New research conducted in mice offers insights into what’s going on at the molecular level that could cause people with diabetes to develop Alzheimer’s disease.

The study adds to a growing body of research on the links between Type 2 diabetes and Alzheimer’s disease, which some scientists have called “Type 3 diabetes.” The findings suggest that it should be possible to reduce the risk of Alzheimer’s by keeping diabetes well controlled or avoiding it in the first place, according to researchers.

Narendra Kumar, an associate professor at Texas A&M University in College Station, led the study.

“We think that diabetes and Alzheimer’s disease are strongly linked,” Kumar said, “and by taking preventative or amelioration measures for diabetes, we can prevent or at least significantly slow down the progression of the symptoms of dementia in Alzheimer’s disease.”

Kumar will present the new research at Discover BMB, the annual meeting of the American Society for Biochemistry and Molecular Biology, which is being held March 23–26 in San Antonio.

Diabetes and Alzheimer’s are two of the fastest-growing health concerns worldwide. Diabetes alters the body’s ability to turn food into energy and affects an estimated 1 in 10 U.S. adults. Alzheimer’s, a form of dementia that causes progressive decline in memory and thinking skills, is among the top 10 leading causes of death in the United States.

Diet is known to influence the development of diabetes as well as the severity of its health impacts. To find out how diet could influence the development of Alzheimer’s in people with diabetes, the researchers traced how a particular protein in the gut influences the brain.

They found that a high-fat diet suppresses the expression of the protein, called Jak3, and that mice without this protein experienced a cascade of inflammation starting with the intestine, moving through the liver and on to the brain. Ultimately, the mice showed signs of Alzheimer’s-like symptoms in the brain, including an overexpressed mouse beta-amyloid and hyperphosphorylated tau, as well as evidence of cognitive impairment.

“Liver being the metaboliser for everything we eat, we think that the path from gut to the brain goes through liver,” Kumar said.

His lab has been studying functions of Jak3 for a long time, he added, and they now know that the impact of food on the changes in the expression of Jak3 leads to leaky gut. This in turn results in low-grade chronic inflammation, diabetes, decreased ability of the brain to clear its toxic substances and dementia-like symptoms seen in Alzheimer’s disease.

The good news, according to Kumar, is that it may be possible to stop this inflammatory pathway by eating a healthy diet and getting blood sugar under control as early as possible. In particular, people with prediabetes — which includes an estimated 98 million U.S. adults — could benefit from adopting lifestyle changes to reverse prediabetes, prevent the progression to Type 2 diabetes and potentially reduce the risk of Alzheimer’s.

https://www.asbmb.org/asbmb-today/science/032324/how-might-diabetes-lead-to-alzheimers

7 lifestyle habits may lower dementia risk for people with type 2 diabetes

From medicalnewstoday.com

• People with type 2 diabetes can be at an increased risk for dementia.
• Researchers are still working to understand how lifestyle factors can modify dementia risk.
• Data from a recent study indicates that people with type two diabetes are at a lower risk for dementia if they practice certain healthy lifestyle choices.

Dementia is a chronic condition that can be debilitating. Since dementia doesn’t have a cure, people often wonder what steps they can take to reduce their risk of developing dementia. A recent study published in Neurology found that for people with diabetes, incorporating certain healthy lifestyle habits was associated with a decreased risk of developing dementia.

Dementia and its risk factors

DementiaTrusted Source is a broad term for disorders that impact people’s ability to remember, think, and reason. It typically gets more severe with time and can significantly interfere with people’s everyday lives and ability to live independently.

Some risk factors for dementia cannot be altered, such as increased age or family history. However, people can modify other risk factorsTrusted Source to reduce risk. For example, smoking, obesity, and excessive use of alcohol are all risk factors for Alzheimer’s disease and related dementias.

Having diabetes is also a risk factor for dementia, particularly type two diabetes. People with diabetes can work with their doctors to manage their condition and improve their health. Research is ongoing about how healthy lifestyle changes can improve conditions like diabetes and reduce dementia risk. ​

Type 2 diabetes, dementia, and lifestyle factors

Researchers in this current study examined how seven healthy lifestyle habits impacted dementia risk. They looked at how these habits helped people with diabetes and those without diabetes. The habits included:

• not currently smoking
• moderate alcohol consumption
• regular physical activity
• eating a healthy diet
• getting adequate amounts of sleep
• less sedentary behaviour
• having frequent social contact

Researchers utilised the U.K. Biobank in their data collection. They included participants ages 60 years or older without dementia at the start of the study. They specifically excluded people with type one diabetes from data collection so that they could focus on individuals with type two diabetes.

​Researchers assigned participants a healthy lifestyle score based on the seven above behaviour factors. Each category had a definition of what researchers classified as healthy. For example, someone was classified as being regularly physically active if they had “at least 150 minutes/week of moderate activity or 75 minutes/week of vigorous activity or an equivalent combination.”

The study included more than 160,000 participants, including more than 12,000 with diabetes. Researchers followed the participants for an average of 12 years. They found that healthy lifestyle factors were associated with a lower risk of developing dementia. But this risk reduction was even more pronounced among participants with diabetes.

Study author, Dr. Yingli Lu, Ph.D., of Shanghai Jiao Tong University School of Medicine in China, noted to Medical News Today:

“Our findings highlight that although patients with diabetes are at a higher risk of developing dementia later compared with those without, adherence to an overall healthy lifestyle may greatly reduce this risk.”

N​on-study author and Alzheimer’s researcher, Jeroen Mahieu, Ph.D., noted to MNT:

“The most important finding of this study is that adhering to a healthy lifestyle substantially reduces the risk of developing dementia for diabetes patients; significantly more than when you do not have diabetes. This is important given the greater prevalence of dementia among diabetes patients. Yet, due to the nature of the data and the research design we should be cautious with interpreting these effects as causal.”

Study limitations and areas for continued research

The study indicates that incorporating healthy lifestyle habits may decrease the risk for dementia, particularly among people with diabetes. However, the study also had several limitations.

​First, information on lifestyle behaviours was self-reported, increasing the risk of data collection errors. Second, the researchers collected lifestyle factor data at baseline and did collect data on lifestyle factor changes. The study did not collect data about lifestyle factors for participants before they developed diabetes.

The researchers also noted that participants they had to exclude based on missing data were more likely to have lower education and socioeconomic status, which may have impacted the results. Based on the data collection methods, the research team acknowledged that they could have misclassified participants with diabetes or prediabetes as not having diabetes.

In addition, although several confounding factors were adjusted for, such as medication use, the authors acknowledged that there could be unknown or unmeasured factors unaccounted for. The study also included mainly Caucasian participants indicating that more diverse studies will be needed in the future.

Nevertheless, the study adds to a growing body of data regarding how lifestyle choices influence health. Dr. Lu explained to MNT:

“Our data may have important implications for doctors, and other medical professionals who treat people with diabetes. [They] should consider recommending lifestyle changes to their patients. Such changes may not only improve overall health but also contribute to the prevention or delayed onset of dementia in people with diabetes. Future research is needed to determine how combined healthy lifestyle behaviours benefit cognitive outcomes in diabetes and the possible mechanisms.”

https://www.medicalnewstoday.com/articles/7-lifestyle-habits-may-lower-dementia-risk-for-people-with-type-2-diabetes 

The Relationship Between Diabetes and Dementia

From beingpatient.com

Here’s a primer on how diabetes is linked with dementia risk, and what you can do to reduce your chances of developing the two health conditions

How can a chronic condition originating from the pancreas double your risk of developing Alzheimer’s or dementia? 

According to the Centers for Disease Control and Prevention, more than 30 million Americans are currently living with diabetes. It occurs when cells in the pancreas are unable to produce enough insulin — a hormone that tells the body to import the sugar circulating in the blood into the body. Because sugar is the main source of fuel for the brain, diabetes symptoms can cause fatigue and cognitive impairment. 

When the brain doesn’t get enough energy, it alters its metabolism and leads to cellular damage. These factors may make it more likely that someone with diabetes develops Alzheimer’s disease, or another form of dementia. Additionally, there are many shared risk factors between these two diseases that further explain their close relationship.

Here’s what diabetes and dementia have in common

One of the largest known genetic risk factors for developing Alzheimer’s in certain populations, ApoE4, is also a major risk factor for developing diabetes. This gene encodes a protein that carries cholesterol, increasing blood pressure. While this protein is too large to enter the brain, it is produced by cells called astrocytes and may trigger the release of amyloid plaques.  

Next, high levels of blood sugar which can contribute to the onset of diabetes are also a risk factor for the development of Alzheimer’s and other forms of dementia. 

A 2013 study, published in the New England Journal of Medicine, found that any abnormal elevations in blood sugar — even in people without diabetes — increased the risk of developing dementia. 

In addition, medications that bring blood glucose under control like metformin are also linked to a reduction in Alzheimer’s risk in people who already have diabetes. 

Black Americans are at an elevated risk of developing diabetes and Alzheimer's. Since the majority of medical research has been conducted on white individuals, studies are seeking to diversify their participants to better understand this risk factor. Meanwhile, poor socioeconomic status which is more common in African American communities is linked to diabetes risk.    

Prevention strategies that work for both diseases

With so many shared risk factors between the two diseases, there is some good news. Many of the same strategies used to prevent diabetes also reduce the risk of developing Alzheimer’s or other forms of dementia. 

A healthy Mediterranean-style diet leads to reductions in cholesterol and blood sugar. Importantly, in the case of brain health, it also means lower risk of developing cognitive impairment. This diet provides a lot of variety in terms of taste, consisting of:

• Fruits, vegetables, and legumes
• Nuts and seeds
• Whole grains
• Fish, seafood and olive oil

Regular exercise also reduces the risk of developing dementia and helps prevent diabetes. During exercise, there is a reduction in blood sugar levels as the body mobilizes it to fuel the muscles. Exercise also may increase the brain's metabolic rate, staving off cellular damage. 

A combination of healthy eating and exercise can jointly fight against diabetes and Alzheimer’s. As scientists look to better understand the relationship between these two diseases, they come closer to finding new treatments for both.

https://www.beingpatient.com/diabetes-dementia-risk-factor/

What People with Type 2 Diabetes Can Do to Lower Their Risk for Cancer, Dementia

From healthline.com

Researchers in Australia say people with type 2 diabetes have a higher risk for developing cancer as well as dementia.

Experts say excess sugar in the body can lead to microvascular damage that can cause dementia by damaging small blood vessels in the brain.

They add that excess sugar can also help feed the growth of cancer cells.

Experts advise people to eat a healthy diet, exercise regularly, and get plenty of sleep to lower their risk for disease.

People with diabetes already face an increased risk for a number of serious health conditions, including nephropathy, retinopathy, and neuropathy.
Now recent research from Australia has concluded that people with type 2 diabetes are up to three times more likely to develop several types of cancer and 60 percent more likely to develop dementia compared to the general population.

The research from the Baker Heart and Diabetes Institute in Melbourne also highlighted serious concerns: Due to the COVID-19 pandemic, fewer people are visiting their doctors for routine screenings and testing.

Researchers say that means diagnosing diabetes, cancer, and early signs of dementia is less likely.
As a direct result of the COVID-19 pandemic, oncology referrals were down by 30 percent, and diabetes screenings have dropped a third in Australia, researchers reported.
Additionally, both pathology and radiology testing — which play a critical role in diagnosing cancer — have dropped by 70 percent.

The risk of dementia

The researchers from the Baker Institute link dementia and diabetes through microvascular damage, which they say can lead to “many small strokes.”
They say that can pave the way to dementia by way of damage in the small blood vessels in the brain.

Other experts say the connection between these two conditions goes deeper.
“The biggest problem is ‘advanced glycogenated end-products’ and inflammation,” explained Dr. Alex Reeves, a neurologist and former professor of neurology at Dartmouth Medical School in New Hampshire.

Advanced glycogenated end-products (AGEs) are essentially the glucose that accumulates and damages both the blood vessels and nerve endings throughout the body.

AGEs accumulate in the bloodstream and contributes to the overall HbA1c level. That damage is what leads to the development of diabetes complications in the eyes, kidneys, fingers, toes, and other parts of the body.

The more AGEs present in your body, the higher your A1C will be.

AGEs are also present in over-cooked meat - especially meat that’s been grilled, broiled, baked, or fried at high heat.

“People with dementia tend to have very high levels of AGEs and microvascular disease. Very few don’t have both,” Reeves told Healthline. “Though some may have more of one than the other.”
AGEs also go hand-in-hand with inflammation, a major contributor to most chronic diseases, explains Reeves.

“You can actually predict dementia, atherosclerosis, neuropathy, and cancer on the basis of AGE levels. AGEs are made up of protein, glucose, and lipid-glucose, and they are highly inflammatory.
“They are an inevitable part of the aging process and you can’t eliminate them 100 percent, because we all need glucose in our bloodstream. What you can do, though, is reduce this process by lowering blood sugar levels and reducing overall inflammation,” Reeves said.

Anti-inflammatory agents reduce the formation of AGEs, which is why some researchers say reducing inflammation is also directly linked with reducing the risk of diabetes.
Reducing blood sugar levels through healthier lifestyle habits inevitably reduces overall inflammation.

Experts say this is why it’s important to exercise: It helps your body burn up excess sugar in your bloodstream, which in turn reduces the development of AGEs.

Excess sugar and cancer

Excess sugar in the bloodstream can also contribute to the risk of cancer.
There are several theories for the increased risk of cancer in people with diabetes, but one possibility echoed in the latest research from the Baker Institute is that excess sugar in the bloodstream feeds the growth of cancer.

“Cancer cells love sugar, so there is suggestion that increased sugar levels mean there is plenty around for cancer to grow more rapidly,” said Dr. Jonathan Shaw, head of clinical diabetes and population health at the Baker Institute.

In addition to a generally increased risk of cancer, the researchers found that people with diabetes were three times more likely to develop pancreatic cancer and twice as likely to develop liver or endometrial cancer.
The risk of developing bowel cancer was 30 percent higher, and 20 percent higher for breast cancer.

Lowering the risk

Experts say lifestyle habits are one of the most impactful areas of your life that you can focus on to improve your current well-being and protect your future health.
Among the recommended lifestyle habits:

• Eat a diet high in plant-based foods.
• Quit smoking.
• Reduce sugar intake in both food and beverages.
• Exercise daily.
• Limit alcohol consumption.
• Get plenty of sleep.
• Lose weight, if necessary.
• Reduce blood sugar levels.

Reeves also recommends a variety of antioxidant supplements known to reduce AGEs by reducing overall inflammation:

• vitamin c
• turmeric
• fat-soluble B-1
• quercetin
• resveratrol
• alpha-lipoic acid

Shaw also emphasizes the need to continue with your routine care appointments despite COVID-19 concerns.
“If we are not careful, we end up with more of a problem from people letting other things lapse than from the coronavirus itself,” he told Healthline.

This means regular blood tests and other medical check-ups are still a must, even during a pandemic.

https://www.healthline.com/health-news/what-people-with-type-2-diabetes-can-do-to-lower-their-risk-for-cancer-dementia#Lowering-the-risk