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This essay talks about Brain Resistance to Insulin if Diabetes Type Two is not treated. High levels of glucose damages blood vessels preventing the brain from receiving the energy it needs to perform its functions properly.

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A study that was conducted to understand how the use of insulin and Alzheimer’s disease in people with diabetes, is related. The experiment occurred in the Khatam-al-Anbia Hospital in Shoushtar. The archives of the patients that were admitted between 2015-2016 were previewed and they all had either type 1 or type 2 diabetes.

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THE RELATIONSHIP BETWEEN USING INSULIN AND SUFFERING ALZHEIMER'S DISEASE IN PATIENTS WITH DIABETES A TWO-YEAR STUDY

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Diabetes is a condition when the body does not have the ability to convert glucose to energy, and this can lead to serious health issues since it’s one of the main energy sources. Insulin and glucose have to work together to send the fuel to the brain.

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What is type 3 diabetes?

Diabetes mellitus (also called DM or diabetes for short) refers to a health condition where your body has difficulty converting sugar to energy. Typically, we think of three kinds of diabetes:

Type 1 diabetes (T1DM) is a chronic health condition in which your body's endocrine part of the pancreas doesn't produce enough of the hormone insulin, and your blood sugar (glucose) level becomes too high.

Type 2 diabetes (T2DM) is a chronic condition in which your body develops resistance to insulin, and your blood sugar level becomes too high as a result.

Gestational diabetes (GDM) is DM that occurs during a pregnancy, and the blood sugar level is too high during this time.

Some research studies have proposed that Alzheimer's disease should also be classified as a type of diabetes, called type 3 diabetes.

This "type 3 diabetes" is a term that has been proposed to describe the hypothesis that Alzheimer's disease, which is a major cause of dementia, is triggered by a type of insulin resistance and insulin-like growth factor dysfunction that occurs specifically in the brain.

This condition also has been used by some to describe people who have type 2 diabetes and are also diagnosed with Alzheimer's disease dementia. The classification of type 3 diabetes is highly controversial, and it's not widely accepted by the medical community as a clinical diagnosis.

The above "type 3 diabetes" medical condition isn't to be confused with type 3c diabetes mellitus (also called T3cDM, pancreatogenic diabetes, and type 3c diabetes).

The pancreas has both endocrine and exocrine glands, and they have their respective functions. Insulin is one of the hormones that beta-islet cells in the Islets of Langerhans, which is endocrine pancreas tissue, produce and secrete.

When the exocrine pancreas becomes diseased and then causes a secondary insult to the endocrine pancreas that ultimately leads to DM, this is T3cDM. Exocrine pancreatic diseases that may lead to T3cDM include pathology such as:

chronic pancreatitis

cystic fibrosis

exocrine pancreatic cancer

Keep reading to find out what we know and what we don't know about "type 3 diabetes." And please keep in mind that this isn't to be confused with type 3c diabetes.

According to the Mayo Clinic, there's already an established link between Alzheimer's and type 2 diabetes. It's been suggested that Alzheimer's may be triggered by insulin resistance in your brain. Some people say that Alzheimer's is simply "diabetes in your brain."

This claim has some science behind it, but it's a bit of an oversimplification.

Over time, untreated diabetes can cause damage to your blood vessels, including vessels in your brain. Many people who have type 2 diabetes don't know that they have the condition, which may delay diagnosis and appropriate treatment measures.

Therefore, those with type 2 diabetes, especially undiagnosed diabetes, have a higher risk of this kind of damage.

Diabetes may also cause chemical imbalances in your brain, which may trigger Alzheimer's. Also, high blood sugar levels lead to inflammation, which may damage brain cells.

For these reasons, diabetes is considered a risk factor for a condition called vascular dementia. Vascular dementia is a stand-alone diagnosis with symptoms of its own, or it can be a warning sign of what will develop into an overlap with Alzheimer's disease.

The science of this process is uncertain. For now, what's been established is that there are cases of Alzheimer's disease and other forms of dementia that don't have any demonstrated link to insulin resistance.

According to a 2016 study, people who have type 2 diabetes may be up to 60 percent more likely to develop Alzheimer's disease or another type of dementia, such as vascular dementia.

This involved more than 100,000 people living with dementia. It showed that women with type 2 diabetes had a higher probability of developing vascular dementia than men.

Risk factors for type 2 diabetes include:

The symptoms of type 3 diabetes are described as the symptoms of dementia, such as those seen in early Alzheimer's disease.

According to the Alzheimer's Association, these symptoms include:

memory loss that affects daily living and social interactions

difficulty completing familiar tasks

misplacing things often

decreased ability to make judgements based on information

sudden changes in personality or demeanor

There's no specific test for type 3 diabetes. Alzheimer's disease is diagnosed based on:

a neurological examination

medical history

neurophysiological testing

Your healthcare provider will ask several questions about your family history and your symptoms.

Imaging studies, such as MRI and CT scans of the head, may give your healthcare provider a picture of how your brain is working. Cerebrospinal fluid testing can also look for indicators of Alzheimer's.

If you have symptoms of type 2 diabetes and Alzheimer's and haven't been diagnosed with either one, your healthcare provider may order a fasting blood sugar test and a glycated hemoglobin test.

If you do have type 2 diabetes, it's important that you begin treatment for it immediately. Treating type 2 diabetes could minimize damage to your body, including your brain, and slow the progression of Alzheimer's or dementia.

There are separate treatment options for people who have:

pre-type 2 diabetes

type 2 diabetes

Alzheimer's

Lifestyle changes, such as making changes to your diet and including exercise in your daily routine, may be a big part of your treatment.

Here are some additional treatment tips:

If you're living with overweight, try to lose 5 to 7 percent of your body mass, according to the Mayo Clinic. This can help stop organ damage caused by high blood sugar and may prevent the progression of pre-DM2 to DM2.

A diet low in fat and rich in fruits and vegetables can help improve symptoms.

If you smoke, quitting smoke is recommended because it can also help manage your condition.

If you have both type 2 diabetes and Alzheimer's, treatment for your type 2 diabetes is important to help slow the progression of dementia.

Metformin and insulin are an anti-diabetes drugs that reduce the risk of developing diabetes-induced brain damage, according to a 2014 study.

Prescription medications are available to treat cognitive symptoms of Alzheimer's dementia, but there's uncertainty about whether they have a noticeable impact on the symptoms of Alzheimer's disease.

Acetylcholinesterase inhibitors like donepezil (Aricept), galantamine (Razadyne), or rivastigmine (Exelon) can be prescribed to improve the way that your body's cells communicate with one another.

Memantine (Namenda), an NMDA-receptor antagonist, may also help to reduce symptoms and slow the progression of Alzheimer's disease.

Other symptoms of Alzheimer's and other dementia types, like mood swings and depression, may be treated with psychotropic drugs. Antidepressants and anti-anxiety medications are part of treatment in some cases.

Some people may need a light dose of antipsychotic therapy later in the course of the dementia process.

Type 3 diabetes is a way of describing Alzheimer's that's caused by insulin resistance inside the brain. So, your outlook will vary according to several factors, including your diabetes treatment and the severity of your dementia.

If you can treat your diabetes with diet, exercise, and medication, researchers who promote the diagnosis of type 3 diabetes suggest that you may be able to slow the progression of Alzheimer's or vascular dementia, but evidence is uncertain.

Your outlook will also vary according to how soon your symptoms were discovered and what your healthcare provider thinks about your specific case. The sooner treatment begins, it's likely the better your outlook will be.

According to the Mayo Clinic, the average life expectancy for a person with Alzheimer's is around 3 to 11 years from the time that they're diagnosed. But some people with Alzheimer's can live as many as 20 years post-diagnosis.

If you already have type 2 diabetes, there are ways that you can better manage it and lower your risk for developing type 3 diabetes.

Here are some of the proven methods for managing type 2 diabetes and minimizing organ damage:

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Type 3 diabetes is the proposed name for a condition that occurs when type 2 diabetes and Alzheimer's disease coexist. It's the name for Alzheimer's or dementia caused by insulin resistance in the brain. Not all scientists agree with it. We'll tell you what you need to know about current research.

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Vasques talks about having a healthy diet. People should read the nutritional label to eat the right serving amount. There should be a control in high blood sugar levels by eating healthy, exercising, and having a goodnight's sleep.

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Diabetes medications aid in the decline of Alzheimer's disease gravity compared to people with Alzheimer's who haven’t taken diabetes drug medications. Diabetes drugs control hyperglycemia letting the blood vessels work in an appropriate way to bring the nutrients to the brain.

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Diabetes medications may reduce Alzheimer's disease severity

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People with Alzheimer's disease who were treated with diabetes drugs showed considerably fewer markers of the disease-including abnormal microvasculature and disregulated gene expressions-in their brains compared to Alzheimer's ...

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Scientist took clinical and biological measurements from people suffering from AD to see how much Alzheimer’s affects the levels of a person’s cognitive impairment. The clinical attributes have been taken and used to try to detect early cognitive impairment in people before it gets too consequential.

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Cognitive performance of older adults in a specialized diabetes clinic

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There is an increased chance of Alzheimer’s and other dementias with people that have diabetes, especially Diabetes Type Two. Not just that, but they also found diabetes is connected to mild cognitive impairment according to a 2018 review. The insulin is vital for the brain's well being and functional abilities.

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With increasing prevalence of both dementia and diabetes, in part because of greater longevity and certain lifestyle factors, there has also been an increase in the co-occurrence of these diseases. ¹ Research has shown that this comorbidity is not simply the result of chance. An increased risk for dementia has been observed among individuals with diabetes, with the vast majority of data pertaining to type 2 diabetes (T2D) specifically. In addition, diabetes has been "linked to forms of cognitive dysfunction that are not as severe as dementia, such as mild cognitive impairment (MCI), but also to even more subtle cognitive changes, which are referred to as diabetes-associated cognitive decrements," according to a 2018 review. ¹

Whereas dementia primarily affects individuals >65 years of age, causing recognizable symptoms with clear progression year to year, diabetes-associated cognitive decrements can affect patients of all ages, are likely develop over a period of many years, and can be difficult to detect through imaging or neuropsychological examination. "Hence, considering these different features, diabetes-associated cognitive decrements and dementia should be regarded as different entities that probably have different underlying mechanisms," added the investigators. 1

Regarding associations with MCI and dementia, the researchers noted the following findings:

One prospective study published in 2014 found a hazard ratio of 1.6 (95% CI, 1.2-2.2) for amnesic MCI and 1.4 (95% CI, 0.8-2.2) for non-amnesic MCI in individuals with diabetes.¹

Prognosis of MCI is worse in those with vs without diabetes, with a 1.7 relative risk for conversion to dementia reported in meta-analyses.¹

In combined results from various studies totaling >2 million participants, the reported relative risk was 1.73 (95% CI, 1.65-1.82) for all types of dementia, 1.53 (95% CI, 1.42-1.63) for Alzheimer disease, and 2.27 (95% CI, 1.94-2.66) for vascular dementia.¹

In other research, the relative risk for all types of dementia was 1.62 (95% CI, 1.45-1.80) in women and 1.58 (95% CI, 1.38-1.81) in men.²

For vascular dementia, women showed a 19% higher risk than men.¹

Increased dementia risk has been observed even in patients with newly diagnosed diabetes (hazard ratio 1.16; 95% CI, 1.15-1.18).³

Endocrinology Advisor interviewed the following experts to explore the mechanisms, clinical implications, and research needs pertaining to the diabetes-dementia link: Marwan Sabbagh, MD, director of the Cleveland Clinic Lou Ruvo Center for Brain Health; Rebecca Gottesman, MD, PhD, professor of neurology and epidemiology in the division of cerebrovascular neurology at Johns Hopkins University, and director of research at Johns Hopkins Bayview Neurology; and David John Irwin, MD, assistant professor of neurology at the Perelman School of Medicine at the University of Pennsylvania.

Endocrinology Advisor: What is known thus far regarding the link between diabetes and dementia and other forms of cognitive dysfunction, and what are the proposed underlying mechanisms?

Dr Sabbagh: There is clearly a risk link between T2D and Alzheimer's dementia. There is no literature around other types of dementia - frontotemporal, Lewy body, or Parkinson's dementia, for example - but there is clearly a link with Alzheimer's. This is particularly true for people with T2D, who are much more likely to [have Alzheimer's dementia] compared [with those without diabetes]. In addition, insulin resistance has been found in the brain of people with Alzheimer's pathology, even if they don't have insulin resistance elsewhere in the body. Suzanne de la Monte of Brown University has published papers stating that Alzheimer's is basically type 3 diabetes. ⁴

Dr Gottesman: There are several probable mechanisms. One possibility is that patients with diabetes experience more clinical or even subclinical strokes, which themselves can [have a direct] impact on cognition, ultimately increasing risk for cognitive impairment or dementia. Another leading hypothesis is that insulin resistance [has an] impact on the brain directly, impairing the brain's ability to respond appropriately to insulin and levels of glycemia. There are a lot of other hypothesized mechanisms, including increased inflammation, which can lead to downstream cognitive problems; alterations in ability to clear toxins in the brain such as amyloid because of adverse effects on blood vessels, might also increase the risk for Alzheimer's dementia specifically.

Dr Irwin: [The links] are not fully understood but likely involve several mechanisms, including cerebrovascular disease induced reductions in brain health. Peripheral insulin resistance in diabetes has a significant impact on vascular health, which includes cerebral vasculature. This chronic damage to cerebral vasculature can cause clinically silent microscopic infarctions in deep white matter of the brain which can impair multiple cognitive functions or lead to increased risk for larger clinically manifested cerebrovascular accidents.

There is also emerging evidence of an important role of insulin in regulating brain function. Patients with T2D and patients with Alzheimer disease without T2D have both been found to have evidence of insulin resistance of brain cells, which may contribute to the pathophysiologic process of cognitive impairment and dementia.

Endocrinology Advisor: How should this risk be monitored and assessed in clinical practice? What are common signs and screening tools, for example?

Dr Sabbagh: We would not routinely test [hemoglobin (Hb)] A1C levels or fasting sugars as part of management or screening of a patient with dementia. That is not a common practice. Not that it couldn't be, but what we would typically do is try to optimize the medical care of their diabetes with drugs to normalize their HbA1C. In turn, we could expect to see some risk reduction, but you might not necessarily see a correlative improvement in cognition.

Dr Gottesman: Standard screening for cognitive impairment isn't necessarily indicated, but if patients or their family members are reporting problems with memory or other aspects of cognition, or certain problems functioning in their daily routine because of cognitive problems, a more detailed initial screening can be considered with a test such as the Montreal Cognitive Assessment or even more detailed neuropsychological testing. Screening for diabetes has value for many disease end points, with more clear benefits from glycemic control.

Dr Irwin: Promotion of healthy aging strategies is helpful to reduce risk for age-associated memory changes in patients with diabetes and in all individuals. These include a heart-healthy diet with tight glucose control and preventive care for other vascular risk factors such as smoking, obstructive sleep apnea, hypertension, and high cholesterol. Regular exercise and cognitive and social engagement are also very helpful to promote healthy aging.

It is important to have regular follow up with a primary care physician to manage these risk factors and to help detect early signs of cognitive impairment. Basic cognitive screening tools are helpful to quantify subjective memory complaints, and referral to a neurologist may be helpful for more detailed evaluation. Reports of functional decline such as needing assistance with complex activities of daily living, including finances or appointments, should prompt further clinical investigation.

Endocrinology Advisor: What are the relevant treatment recommendations and other important implications for clinicians?

Dr Sabbagh: There is a currently a convergence of data going on around that very question. There have been many studies [investigating] treatment of Alzheimer's using diabetic drugs. The glitazones Actos (pioglitazone) and Avandia (rosiglitazone) were tried in Alzheimer's dementia. ⁵ The Avandia data was equivocal. There was a large prevention trial (the TOMORROW trial) that was just closed to enrollment. The investigators used a low-dose of pioglitazone as a prevention strategy to reduce the probability of progression to Alzheimer's dementia. The trial stopped because of futility. ⁶ There have also been studies suggesting that metformin could be used as a treatment for Alzheimer's, ⁷ so there is now an ongoing clinical trial on metformin as a treatment for Alzheimer's dementia.

Finally, and probably most intriguing, my colleague Suzanne Craft at Wake Forest has demonstrated that administration of insulin itself could have robust effects. ⁸ The problem, of course, is if you give insulin to a normal person, you're going to crash their sugars, so she has come up with a brilliant pathway - intranasal administration. This allows delivery of insulin to the brain, which has been shown to have multiple mechanisms of action. For one, it affects insulin-degrading enzyme and can facilitate more rapid amyloid turnover. She is preparing to announce the results of a phase II program of intranasal insulin treatment for Alzheimer's dementia.

Dr Gottesman: Although there's growing evidence that diabetes, and even HbA1c level, is associated with risk for cognitive impairment and dementia, there is no clear evidence that treating diabetes with intensive control is beneficial for cognitive outcomes. For example, the ACCORD MIND trial failed to show a benefit in cognitive outcomes in the intensive group, although brain volumes were slightly better in the intensive group. ⁹ However, this is probably because relationships between diabetes and dementia take many years or even decades to occur, and clinical trials lasting just a few years are unlikely to note a benefit of treatment.

Thus, it seems that maintaining glucose within a normal range is likely to be helpful for cognitive end points, although this is not supported by data. Avoiding hypoglycemia is also likely to be important, however, since there's evidence that episodes of severe hypoglycemia are associated with poor cognitive outcomes.

Dr Irwin: If there is evidence for a decline in cognitive function over time, either by history or objectively on serial evaluations, it is important to have the patient referred for a comprehensive evaluation for a possible early stage of Alzheimer disease or related dementia. This includes a careful history, examination, and often ancillary tests to help exclude reversible causes of cognitive impairment with aging. Treatment of dementia is largely supportive with a benefit of early intervention to help reduce risk for safety issues, such as driving or leaving the stove on, while providing support to encourage socialization and cognitive stimulation.

Endocrinology Advisor: What should be the focus of future research on the dementia-diabetes connection?

Dr Sabbagh: Research should continue in the current directions. There are a lot of unanswered questions, including whether we can we use diabetic medications effectively as a treatment for Alzheimer's dementia. The reason we think about this is that if you look at positron emission tomography scans, you can see that [fludeoxyglucose] metabolism is compromised or altered in Alzheimer's brains, particularly in the frontotemporal regions. That's potentially a marker of neurodegeneration. The question, then, is can we enhance metabolic activity and sugar metabolism in the brain? And the logical target would be the use of diabetic medications. [The findings thus far indicate] that there is clearly a strong intersection between diabetes and diabetic therapeutics and Alzheimer's.

Dr Gottesman: More research needs to continue to evaluate mechanisms of diabetes' effects on the brain but also on treatment and prevention. In addition, individuals with diabetes frequently have other vascular risk factors, and it's apparent that having several uncontrolled risk factors is especially associated with bad cognitive outcomes. Thus, focusing research on multimodal interventions is likely to be important in [future] studies, with several ongoing trials currently evaluating these multimodal approaches.

Dr Irwin: Further understanding of mechanisms of peripheral and central insulin resistance in relationship to brain health, as well as Alzheimer disease and vascular pathology, will be very useful to identify preventative and mechanistic treatment strategies for age-associated memory loss.

Edited and revised for clarity by Endocrinology Advisor.
References
1. Biessels GJ, Despa F. Cognitive decline and dementia in diabetes mellitus: mechanisms and clinical implications. Nat Rev Endocrinol. 2018;14:591-604.

2. Chatterjee S, Peters SAE, Woodward M, et al. Type 2 diabetes as a risk factor for dementia in women compared with men: a pooled analysis of 2.3 million people comprising more than 100,000 cases of dementia. Diabetes Care. 2016;39(2):300-307.

3. Haroon NN, Austin PC, Shah BR, Wu J, Gill SS, Booth GL. Risk of dementia in seniors with newly diagnosed diabetes: a population-based study. Diabetes Care. 2015;38(10):1868-1875.

4. de la Monte SM, Wands JR. Alzheimer's disease is type 3 diabetes-evidence reviewed. J Diabetes Sci Technol. 2008;2(6):1101-1113.

5. Miller BW, Willett KC, Desilets AR. Rosiglitazone and pioglitazone for the treatment of Alzheimer's disease. Ann Pharmacother. 2011;45(11):1416-1424.

6. Takeda. Takeda and Zinfandel Pharmaceuticals Discontinue TOMMORROW Trial Following Planned Futility Analysis [news release]. https://www.takeda.com/newsroom/newsreleases/2018/takeda-tommorrow-trial/. January 25, 2018. Accessed September 19, 2018.

7. Luchsinger JA, Perez T, Chang H, et al. Metformin in amnestic mild cognitive impairment: results of a pilot randomized placebo controlled clinical trial. J Alzheimers Dis. 2016;51(2):501-514.

8. Craft S. Therapeutic effect of intranasal insulin on cognition, function, and AD biomarker. Grantome - National Institutes of Health. http://grantome.com/grant/NIH/RF1-AG041845-01. Accessed September 10, 2018.

9. Launer LJ, Miller ME, Williamson JD, et al. Effects of randomization to intensive glucose lowering on brain structure and function in type 2 diabetes ACCORD Memory in Diabetes Study. Lancet Neurol. 2011;10(11):969-977.

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Update on the T2D-Dementia Link: Interview With Experts - Endocrinology Advisor

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With increasing prevalence of both dementia and diabetes, in part because of greater longevity and certain lifestyle factors, there has also been an increase in the co-occurrence of these diseases. 1 Research has shown that this comorbidity is not simply the result of chance.

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The brain as well as the body will age over time. The unfortunate news is that the body's organs and everything also go failing as you get older. The brain is one of your organs that begins neglecting and will be more at risk of a disease. One disease that targets the brain is Alzheimer’s. “Aging is associated with severe changes at the CNS barriers. These changes compromise the function of the barrier, and the defects are more severe in Alzheimer’s disease.”

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The effect of aging on brain barriers and the consequences for Alzheimer's disease development

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This website describes the pancreas, and it is an organ located behind the stomach surrounded by the small intestine, liver, and spleen and it is about six to ten inches long. It is divided in four parts: head, neck, body, and tail.

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The pancreas is an organ located in the abdomen. It plays an essential role in converting the food we eat into fuel for the body's cells. The pancreas has two main functions: an exocrine function that helps in digestion and an endocrine function that regulates blood sugar.

Location of the Pancreas

The pancreas is located behind the stomach in the upper left abdomen. It is surrounded by other organs including the small intestine, liver, and spleen. It is spongy, about six to ten inches long, and is shaped like a flat pear or a fish extended horizontally across the abdomen.

The wide part, called the head of the pancreas, is positioned toward the center of the abdomen. The head of the pancreas is located at the juncture where the stomach meets the first part of the small intestine. This is where the stomach empties partially digested food into the intestine, and the pancreas releases digestive enzymes into these contents.

The central section of the pancreas is called the neck or body.

The thin end is called the tail and extends to the left side.

Several major blood vessels surround the pancreas, the superior mesenteric artery, the superior mesenteric vein, the portal vein and the celiac axis, supplying blood to the pancreas and other abdominal organs.

Almost all of the pancreas (95%) consists of exocrine tissue that produces pancreatic enzymes for digestion. The remaining tissue consists of endocrine cells called islets of Langerhans. These clusters of cells look like grapes and produce hormones that regulate blood sugar and regulate pancreatic secretions.

Functions of the Pancreas

A healthy pancreas produces the correct chemicals in the proper quantities, at the right times, to digest the foods we eat.

Exocrine Function:

The pancreas contains exocrine glands that produce enzymes important to digestion. These enzymes include trypsin and chymotrypsin to digest proteins; amylase for the digestion of carbohydrates; and lipase to break down fats. When food enters the stomach, these pancreatic juices are released into a system of ducts that culminate in the main pancreatic duct. The pancreatic duct joins the common bile duct to form the ampulla of Vater which is located at the first portion of the small intestine, called the duodenum. The common bile duct originates in the liver and the gallbladder and produces another important digestive juice called bile. The pancreatic juices and bile that are released into the duodenum, help the body to digest fats, carbohydrates, and proteins.

Endocrine Function:

The endocrine component of the pancreas consists of islet cells (islets of Langerhans) that create and release important hormones directly into the bloodstream. Two of the main pancreatic hormones are insulin, which acts to lower blood sugar, and glucagon, which acts to raise blood sugar. Maintaining proper blood sugar levels is crucial to the functioning of key organs including the brain, liver, and kidneys.

Diseases of the Pancreas

Disorders affecting the pancreas include pancreatitis, precancerous conditions such as PanIN and IPMN, and pancreatic cancer. Each disorder may exhibit different symptoms and requires different treatments.

Pancreatitis

Pancreatitis is inflammation of the pancreas that occurs when pancreatic enzyme secretions build up and begin to digest the organ itself. It can occur as acute painful attacks lasting a matter of days, or it may be a chronic condition that progresses over a period of years.

Learn more about pancreatitis, its causes, and treatment options.

Precursors to Pancreatic Cancer

The exact cause of pancreatic cancer is still unknown, but there are known risk factors that increase the risk of developing the disease. Cigarette smoking, a family history of pancreatic cancer or hereditary cancer syndromes, and chronic pancreatitis are some of these factors. In addition, certain pancreatic lesions such as Intraductal Papillary Mucinous Neoplasms (IPMNs) and Pancreatic Intraepithelial Neoplasia (PanIN) are considered precursors to pancreatic cancer.
Read more about the precursors to pancreatic cancer.
Pancreatic Cancer

The most common form of pancreatic cancer is pancreatic adenocarcinoma, an exocrine tumor arising from the cells lining the pancreatic duct. A far less common form, endocrine tumors, account for less than 5% of all pancreatic tumors and are sometimes referred to as neuroendocrine or islet cell tumors.
Learn more about different forms of pancreatic cancer and their treatments.

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The pancreas is an organ located in the abdomen. It plays an essential role in converting the food we eat into fuel for the body's cells. The pancreas has two main functions: an exocrine function that helps in digestion and an endocrine function that regulates blood sugar.

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Scientists find new medicine to treat brain disorders, but the problem is that they don't know how to send it to the brain. It's complicated to send medicines to the brain because it has a security system to keep things out. "Dr. William Pardridge, a brain researcher at the University of California at Los
Angeles, estimates that 95 percent of drugs discovered using the latest technologies
will not get into the brain."

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Scientists Find New Ways To Break Into the Brain

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The connection between Type 2 Diabetes (T2D) and Alzheimer’s Disease is so strong that many researchers have begun to call it Type 3 Diabetes (T3D). If the brain doesn't receive the necessary energy, brain cells start to die because our brain needs energy.

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Alzheimer's disease is a type of progressive dementia that affects more than 5 million Americans, and those rates are projected to increase dramatically over the next several years. One link to Alzheimer's disease that researchers are exploring is diabetes. There have been several studies that have connected the two diseases together. In fact, some researchers have begun to call Alzheimer's disease "type 3 diabetes."

Although a small amount of research found an increased risk of dementia with type 1 diabetes, the vast majority of studies have concluded that this link between diabetes and Alzheimer's is specific to t ype 2 diabetes.

Type 2 diabetes develops when insulin becomes less efficient at processing sugar through the bloodstream. Studies show that approximately half of people with type 2 diabetes will go on to develop Alzheimer's disease. With such a strong connection, the focus of some research studies is to explain the connection between the two disease.

Type 3 Diabetes

In type 1 or 2 diabetes, not enough insulin (or none at all) is produced to process glucose (sugar) correctly or the body no longer responds to insulin, and it affects the functioning fn the whole body. In Alzheimer's disease, it appears that a similar problem is occurring, but instead of causing problems in the entire body's functioning, the effects occur in the brain.

Researchers found interesting evidence of this when they studied people's brains after their death. They noted that the brains of those with Alzheimer's disease who did not have type 1 or type 2 diabetes showed many of the same abnormalities of those with diabetes, including reduced levels of insulin in the brain. This led researchers to conclude that perhaps Alzheimer's is a brain-specific type of diabetes which they termed "type 3 diabetes."

In diabetes, if a diabetic person's blood sugars become too high or too low, the body sends very obvious signs of the problem: behavior changes, confusion, seizures, etc. In Alzheimer's disease, however, rather than those acute signals of a problem, the brain's function and structure decline gradually over time.

When a group of researchers reviewed the collections of studies available on Alzheimer's disease and brain function, they noted that a common finding in Alzheimer's disease was the deterioration of the brain's ability to use and metabolize glucose. They compared that decline with cognitive ability and noted that the decline in glucose processing coincided with, or even preceded, the cognitive declines of memory impairment, word-finding difficulty, behavior changes, and more.

Furthermore, scientists determined that as insulin functioning in the brain worsens, not only does the brain's cognitive ability decline, the size and structure of the brain also deteriorate-all things that occur as Alzheimer's disease progresses.

Does Type 2 Diabetes Cause Alzheimer's Disease?

Research is ongoing about this question, but one study suggests that while diabetes likely exacerbates and contributes to the development of Alzheimer's disease, it is probably not the sole cause of it.

In this study, scientists fed mice a high-fat diet which induced the development of type 2 diabetes. They then studied the mice and found that a higher amount of tau protein was present in their brains, and the mice also developed a resistance to brain insulin. Additionally, the brain structure of these mice also deteriorated somewhat on the high-fat diet; however, the cognitive functioning of these mice did not decline significantly to the level they would if Alzheimer's disease was present.

While this study was conducted with mice, scientists believe that it might also hold true in humans.

Looking at What Causes Alzheimer's Disease

So, what does cause Alzheimer's if type two diabetes is not the culprit? Researchers have for decades been attempting to determine the specific cause of Alzheimer's disease. While they can diagnose it conclusively with an autopsy of the brain because they know what it looks like and how it affects the structures of the brain, they haven't been able to figure out for certain what really triggers the changes in the brain that are noted in Alzheimer's.

Scientists have, however, determined several ways to reduce your risk of developing Alzheimer's disease, including a healthy diet, physical activity, and mental stimulation, among many others.

If Alzheimer's disease is another type of diabetes, would medications for diabetes help people with Alzheimer's? Several research studies have begun to look at this possibility and seem to indicate that this may be possible. In both animal and human studies, research has demonstrated that these insulin medications have protected against the structural abnormalities that develop in Alzheimer's disease, have improved the brain's ability to metabolize glucose, and have even demonstrated an improvement in the brain's cognitive functioning in some cases.

A Word from Verywell

The possible connection between Alzheimer's and diabetes is an interesting one, and one which requires more research to solidify. In the meantime, if you have diabetes and are concerned about your risk of developing Alzheimer's disease, talk with your physician about your best treatment options, which may include a healthy lifestyle and diet, exercise and medication.

Thanks for your feedback!

What are your concerns?

Other Inaccurate Hard to Understand

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Why Alzheimer's Disease Is Called Type 3 Diabetes

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Alzheimer's disease is a type of progressive dementia that affects more than 5 million Americans, and those rates are projected to increase dramatically over the next several years. One link to Alzheimer's disease that researchers are exploring is diabetes. There have been several studies that have connected the two diseases together.

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Latinos are more likely to develop diabetes because of the consumption of an excess amount of carbohydrates or sugar. People need to have a healthy diet.

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For decades, Martin Gomez enjoyed tacos and burritos without a care. The carbohydrate-laden comfort food kept him energized so he could work hard, bringing his paychecks home from his job as a landscaper to support his extended family. But little did he realize that same food would one day threaten everything.

Gomez, a 56-year-old Hispanic resident of Houston, was diagnosed with type 2 at a health fair about 15 years ago. Because diabetes requires blood sugar management through diet and lifestyle changes, as well as medication in many cases, he worried whether he would be able to keep his job in landscaping or whether he would ever be able to eat his family's cooking again. He wasn't sure he would have enough time in the day to work in exercise, diet tracking, pharmacy visits and doctor's visits. Poorly managed diabetes can lead to life-threatening complications such as kidney disease, cardiovascular disease, neuropathy, and vision issues. At first, Gomez says through a translator, his diabetes diagnosis "felt like a death sentence."

Why There Are Higher Rates of Diabetes Among Hispanic People

Gomez's situation is hardly unusual. According to the Centers for Disease Control and Prevention (CDC) , 50 percent of Hispanic adults in the United States are expected to develop the chronic disease type 2 diabetes - a rate that is higher than for the average adult, who has a 40 percent likelihood of developing type 2 diabetes. The CDC also estimates that Hispanic people are 50 percent more likely to die from the disease than white people are.

While Hispanic people overall are estimated to be at a higher risk for diabetes, they're not the only group: The prevalence of diabetes is also higher among Alaska Natives, Native Americans, and black people, according to the American Diabetes Association . suggests various factors, including those related to genetics, lifestyle, and metabolism, likely play a role in these individuals' greater risk.

An article published in August 2014 in Diabetes Care described research that found the combination of a lack of awareness, health insurance disparities, and low household income may also play a role in the higher rates among Hispanic individuals in particular. And specific subgroups within the Hispanic community seem to be at various risks of developing type 2 diabetes, the article explains: For instance, while the prevalence of diabetes was highest in Mexicans, at 18.3 percent, it was lowest in South Americans, at 10.2 percent. Gomez said he didn't realize the high-carb food he was eating constantly was setting him up to get type 2 diabetes.

Prioritizing Your Health Is Crucial for Disease Control and Prevention

Experts agree that the higher risk of diabetes in Hispanics is very real, but because some of the factors at play come down to individual control, people who may be concerned about diabetes - including those who either have a family history of the disease or have been diagnosed with prediabetes - can feel empowered to change their health outcomes.

Often, for Hispanic people, preventing or managing diabetes comes down to household and cultural norms, says Adlia Ebeid, PharmD, the director of pharmacy services at the San José Clinic in Houston. "They have family and social responsibilities that supersede their health, and historically speaking, they're usually being diagnosed in an emergency care situation, so prevention is not on their radar," Ebeid says, referring to her lower-income Hispanic patients.

Gomez explains it can be difficult to make lifestyle changes when you receive a type 2 diabetes diagnosis, but this feat can be especially challenging when your culture seemingly pushes back against your health goals. As a Hispanic man, he says his struggle was twofold: He needed to work and to help his family, so he was taught that he didn't have time for personal things like and stress management - two factors experts agree are imperative for preventing and controlling diabetes. And then there's the problem with food.

"The tacos, the burritos, gorditas, menudo, pozole," he says - all those high-carb, greasy dishes contributed to why he battles with type 2 diabetes today. "I still eat similar foods, but they're the healthier options."

Gomez says that, to gain control over diabetes, he needed to think about health in a different way and learn how to care for his body as a way to care for his family. He still eats tacos - they're delicious, after all - but he chooses baked tortillas and lean rather than fatty meats for filling. "The big thing is if I want to eat one of my traditional meals, I'll eat less of that and add vegetables to my plate," he says.

Gomez will also peruse the local grocery store and buy prepared meals, particularly salads, until he finds one he really enjoys. Then he'll find the ingredients in the store to make that salad at home - ones with lots of vegetables.

Ebeid says she encourages her patients to eat fewer tortillas, such as just one on a taco instead of stacking them up, and to see them as part of a special meal instead of an everyday utensil.

Family Support Is Also Crucial for Diabetes Prevention in Hispanic Families

She says it was also essential to bring her patients' children and other family members into conversations about type 2 diabetes because those relationships are important for long-term support.

"There's a lot to be said about how family-oriented this culture is and how they rely on different members for different roles," says Ebeid, adding that children will often take the initiative to "hold their parents accountable." She said they will encourage their parents to prepare healthy dinners for the family, will push them to exercise, and will sometimes exercise with their parents for encouragement.

Figuring out how to keep his lifestyle similar while still making healthy changes has been complicated, but Gomez says he feels "optimistic" about his health now.

His advice to anyone who is Hispanic who has recently been diagnosed with type 2 diabetes? It's all going to be okay - diabetes isn't a death sentence - but you need to make some changes.

"Don't stress out over that; don't get overwhelmed. Listen to the doctor's advice, and start making changes on your own," he says. "What we do eat, it's not the healthiest of foods, so start making those gradual changes."

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Why Are Hispanics at an Increased Risk for Type 2 Diabetes?

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For decades, Martin Gomez enjoyed tacos and burritos without a care. The carbohydrate-laden comfort food kept him energized so he could work hard, bringing his paychecks home from his job as a landscaper to support his extended family. But little did he realize that same food would one day threaten everything.

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People with type two diabetes have a high risk of developing Alzheimer’s and other dementia diseases because of damage to blood vessels that end up reducing or stopping blood flow to the brain.

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Diabetes and Alzheimer's linked

Diabetes may increase your risk of Alzheimer's. But blood sugar control, exercise and a healthy diet may help.
By Mayo Clinic Staff
There's a lot of research suggesting a connection between diabetes and Alzheimer's - though those connections aren't yet fully understood. Not all studies confirm the connection, but many do suggest that people with diabetes, especially type 2 diabetes, are at higher risk of eventually developing Alzheimer's dementia or other dementias.

Research is still unclear on whether taking steps to prevent or control diabetes may help reduce your risk of cognitive decline.

Understanding the connection

Diabetes can cause several complications, such as damage to your blood vessels. Diabetes is considered a risk factor for vascular dementia. This type of dementia occurs due to brain damage that is often caused by reduced or blocked blood flow to your brain.

Many people with diabetes have brain changes that are hallmarks of both Alzheimer's disease and vascular dementia. Some researchers think that each condition fuels the damage caused by the other.

Ongoing research is aimed at trying to better understand the link between Alzheimer's and diabetes. That link may occur as a result of the complex ways that type 2 diabetes affects the ability of the brain and other body tissues to use sugar (glucose) and respond to insulin.

Diabetes may also increase the risk of developing mild cognitive impairment (MCI), a condition in which people experience more thinking (cognitive) and memory problems than are usually present in normal aging. Some research indicates that diabetes may increase the risk of MCI worsening to dementia. Mild cognitive impairment may precede or accompany Alzheimer's disease and other types of dementia.

As researchers examine the connections between diabetes and Alzheimer's, they're also studying potential ways to prevent or treat both diseases. But a recent trial of intranasal insulin showed no cognitive benefit.

Reducing your risk

Working with your health care team to prevent diabetes or manage your diabetes has been shown to be an effective strategy to avoid or reduce complications. Diabetes prevention or effective diabetes management may also help prevent Alzheimer's disease and other dementias.

Preventing diabetes or managing it successfully may help you avoid other complications, such as:

Heart disease

Stroke

Eye damage

Kidney disease

Nerve damage, which may cause pain in your feet or hands (diabetic neuropathy)

Digestive problems (gastroparesis)

Bone and joint problems

Steps to prevent or manage diabetes and avoid potential complications include:

Follow your health care team's recommendations about the most appropriate plan for monitoring your blood glucose, cholesterol level and blood pressure.

Eat healthy foods, including fruits, vegetables, whole grains, lean meats, and low-fat milk and cheese.

If you're overweight, eat a healthy diet and exercise to lose weight. Obesity can lead to diabetes and other health problems.

Don't smoke.

Aim to exercise for at least 30 minutes every day.

Examine your feet daily for sores.

Take any prescribed medications on schedule.

Evidence suggests that diet and activity changes that lead to weight loss are especially effective in reducing diabetes risk.

Even small steps can make a big difference. In a major clinical research study, participants with blood sugar levels slightly above normal (prediabetes) cut their risk of developing type 2 diabetes by more than 50 percent through exercise (30 minutes five days a week) and as little as a 5 to 7 percent loss in body weight. That weight loss translates to 10 to 14 pounds (4.5 to 6.4 kilograms) for a 200-pound (about 91-kilogram) person.

See more In-depth

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The link between diabetes and Alzheimer's

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Diabetes may increase your risk of Alzheimer's. But blood sugar control, exercise and a healthy diet may help. By Mayo Clinic Staff There's a lot of research suggesting a connection between diabetes and Alzheimer's - though those connections aren't yet fully understood.