Diabetes and the Brain

By Eileen B. Wyner, NP
Bulfinch Medical Group

Eileen Wyner, NP

I’m confident that I’m not the only one who frequently goes wild because I can’t remember where I put my T-Pass, or my wallet or gloves. I know I had them, but  can’t remember where I put them. Little memory lapses like these happen to everyone no matter  how old you are, and it’s  a pretty normal occurrence.  However, there is potentially another side that worries all of us:  When are these common lapses more than just that? When is it a signal that something is seriously wrong, like the beginning of dementia or Alzheimer’s disease?

Let me start by defining these two illnesses. Dementia is a syndrome caused by a group of brain disorders, Alzheimer’s disease being the most common cause. There is a loss of memory, language, and judgment which interferes with activities of daily living. Alzheimer’s is a fatal disease characterized by progressive worsening of these symptoms thought to be due to abnormal clumps of protein in the brain.

There have been studies conducted showing people with  Type 2 Diabetes have a higher risk of developing Alzheimer’s disease and  other types of dementia later in life, though the exact connection between these conditions isn’t well understood and is still being studied. (It still isn’t clear if people with Type 1 Diabetes have the same increased risk.) There are a few possibilities to consider, however. Type 2 Diabetes is a condition that means there is insulin resistance and insulin deficiency. Inadequate insulin means glucose can’t get from the bloodstream to the cells of the body that keep it healthy and working well. This can lead to damage of the blood vessels anywhere in the body, including the brain.  This damage may go on to cause a decrease in blood flow and even blockages of the vessels. This series of events can lead to vascular dementia.

Hypoglycemia (low blood sugar) has also been indicated as a possible cause of decreased mental functioning. Glucose is the main source of energy for the brain. When you have a low blood sugar, there isn’t enough available to fuel the brain which causes decreased brain function. There is also the possibility that frequent and prolonged hypoglycemia may cause some brain damage to the cerebral cortex (the outermost covering of the brain) and the hippocampus (area responsible for memory).

There is continuous medical investigation underway to better understand the disease process of both diabetes and dementia, and achieve cures for these diseases.  What I hope you will take away with this information is an understanding that there are steps that you can take to help stay as healthy with diabetes as is possible.  Good blood sugar control is the key.  Discuss your self-monitoring goals and HbA1C range with your health care provider at your next visit as these are different for every person.  Taking care of your health is the best holiday gift you can give to yourself and your loved ones.