Insulin And Weight Gain In Type 2 Diabetes Research Articles Type 3 Diabetes – (Less) Food For Thought?

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Type 3 Diabetes – (Less) Food For Thought?

With pre-diabetes and diabetes both increasing at astronomically high rates, new research describes the direct correlation between sugar imbalance and Alzheimer’s disease (AD). Doctors are taught that diabetes can have a negative effect on the kidneys, cardiovascular and nervous system. One organ that gets less attention for poor blood sugar control is the brain. Research confirms that increased body mass index and diabetes, which are a result of a diet higher in carbohydrates, are associated with AD, the most common form of dementia.

A recent study explained this phenomenon. Fifty healthy subjects (average age of 60) were placed in one of three groups: 30% caloric restriction, 20% increase in omega-3 fatty acid intake, or no dietary change. An impressive conclusion for this small but important study was that the group that was calorie restricted had a significant improvement in verbal memory of 20% (1). In addition, after 3 months, it was found that weight, fasting insulin levels, and very sensitive C-reactive protein levels (a marker of inflammation around heart tissue) decreased only in the calorie restriction group, but not in the other two groups.

It should be pointed out that the FDA would probably have approved any pharmaceutical that promised a 20% improvement in verbal memory. Diet modification may be a safer way to achieve the same goal. Physicians and nutritionists should strongly consider incorporating the results of this study when counseling AD patients about diet. A healthy diet is not only for the heart, but also for the brain.

The above research has its roots in a groundbreaking study referred to as the Rotterdam study published in 1999 in the journal Neurology (2). The study showed that diabetes mellitus almost doubled the risk of AD. The new term “Type 3 diabetes” links insulin resistance to AD.

In type I diabetes, there is a lack of insulin production, requiring patients to resort to insulin injections to help regulate glucose levels. In type II diabetes, there is resistance at the cellular level to the insulin that is produced. These patients require a strict diet with low glycemic index and medications as needed. Sometimes, with poorly controlled type II diabetes, insulin is also needed. Type-3 diabetes has elements of both type-1 and type-2 diabetes in that there is both a decrease in the production of insulin and a resistance to insulin receptors.

Type-3 diabetes was coined by Dr. Suzanne de la Monte, a neuropathologist at Brown Medical School in 2005 (3). Dr. de la Monte and her team looked at post-mortem brain tissue from patients suffering from AD and found that AD may actually be a neuroendocrine disease associated with insulin signaling.

In addition to regulating blood sugar levels, insulin functions as a growth factor of all cells, including neurons in the brain. Thus, insulin resistance or lack of insulin contributes to degenerative processes in the brain (4).

A group of researchers at Northwestern University found the likely mechanism of action behind why brains of AD patients are both low in and resistant to insulin. According to Dr. William Klein, who led the research, a neurotoxic molecule called ADDL (amyloid beta-derived diffusible ligand) may be responsible for the phenomenon. ADDLs are some help to explain why Alzheimer’s patients have lowered insulin levels and insulin resistance in their brain.

In a healthy brain, insulin binds to a receptor at a synapse, a specialized junction that connects cells allowing them to communicate with each other. Once this happens, a mechanism is initiated that allows memories to be formed. It was found by Dr. However, Klein’s team that ADDLs disrupt this mechanism of communication (5). ADDLs bind to the synapses, changing their shape. Because their shapes have changed, insulin cannot effectively bind to the synapses as they normally would. This in turn makes the cells insulin resistant, as in type II diabetes.

Proactively applying this constellation of new medical research is critical, especially if the intervention is benign. Neglecting to recommend simple dietary changes to an AD patient can be potentially harmful, leading to rapid cognitive decline. Diet and other lifestyle changes should not be overlooked when treating Alzheimer’s disease.

References:

1. Witte AV et al. Calorie restriction improves memory in older people. Proc Natl Acad Sci USA 2009 Jan 27;106:1255.

2. A. Ott et al, Diabetes and the risk of Dementia: Rotterdam Study, Neurology 1999; 53: 1937

3. de la Monte, Journal of Alzheimer’s Disease, March 2005

4. Li L, Holscher C. Common pathological processes in Alzheimer’s disease and type 2 diabetes: a review. Brain Res Rev. 2007 Dec;56(2):384-402. Epub 2007 Sep 11

5. Alzheimer’s disease affected brain: Presence of oligomeric Aβ ligands (ADDLs) suggests a molecular basis for reversible memory loss (Gong Y et al, PNAS, 2003)

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