Type 1 and Type 2 Diabetes: What's the Link to Brain Health?

Diabetes is an epidemic in the United States, with more than 34 million Americans living with the condition. An astounding 14.2% of the adult population in Louisiana contributes to this figure.

How does diabetes affect the body?

Insulin delivers glucose (sugar) from our bloodstream to our muscle, fat and liver cells to store and use as fuel when needed. Glucose is an energy source; it is literally our body’s fuel for multiple cell functions. We need it, but like most things in life, too much of something is a bad thing.

Those with diabetes lack the ability to produce enough insulin. Without an adequate amount of insulin, glucose stays in the bloodstream at higher concentrations. Over time, this uncontrolled glucose can lead to multiple side effects, including intellectual (cognitive) and mental complications. In fact, researchers are studying a possible link between diabetes and dementia.

What’s the difference between Type 1 and Type 2 diabetes?

While diabetes can be classified in multiple ways, most patients will fall into one of two groups: Type 1 or Type 2.

Those with Type 1 diabetes are born with it. Type 1 diabetes is a rare autoimmune condition in which the body can’t produce insulin, a substance your body needs to control blood sugar.

Patients with the more common Type 2 diabetes still produce insulin but have lost their ability to produce insulin like they once did. Typically, risk increases for developing Type 2 diabetes if you:

• are overweight, have more belly fat
• lack consistent physical activity
• are over the age of 45
• have a family history of Type 2 diabetes
• are a woman diagnosed with gestational diabetes during pregnancy

For years, researchers have studied the effect of blood sugar on cognitive (brain) function. With Type 2 diabetes on the rise, the need to identify methods of prevention and treatment has intensified.

In addition to other cognitive complications associated with diabetes, a link between diabetes and dementia may exist. Though there is still much left to be understood, people with diabetes seem to have a higher incidence of “all-cause” dementia, i.e., dementia that is not specifically linked to a one factor, than people with normal blood sugars.

Why do people with Type 2 diabetes seem to have a higher incidence of all-cause dementia?

We are still working to figure that out. The effects of hyperglycemia (elevated blood sugar) and other aspects of diabetes on the brain are areas of intense research.

Research has taught us some key points already:

1. Heart health is related to brain health. Diabetes raises the risk of heart disease and stroke secondary to damaging blood vessels from high concentrations of glucose over time. Damaged blood vessels hurt the heart and may contribute to damaged blood vessels in the brain, causing cognitive decline.
2. When we have a higher-than-normal concentration of glucose in our blood, it may unbalance the concentration of other factors in our bloodstream. It is thought that these concentration changes may lead to cognitive decline.
3. High glucose concentration leads to inflammation. Inflammation damages our vessels and cells and may also lead to cognitive decline.
4. While more data is needed, there is a link found between insulin resistance and plaque formation in the brain, leading to cognitive decline.

One point that is clear: You can reduce the risk of developing Type 2 diabetes, complications of diabetes and, perhaps, diabetes-related dementia.

What can I do to lower my risk?

Now that you know the risks and possible effects of uncontrolled high glucose over time, this is the good news: Diabetes is an ongoing condition, but with proper treatment, including changes to your lifestyle and appropriate medications, you can control it. Over time, the control of your glucose concentration will slow and/or prevent the outcomes reviewed above.

If you are concerned that you may have diabetes, reviewing your most recent blood sugar level with your doctor is a great starting point. Contact your primary care team to review your risks and work together to formulate a plan.

Think of one small change you can make to improve your lifestyle and health outcomes. Increasing physical activity is one example. Can you walk around the block after dinner? Can you step away from work for 15 minutes twice a day to clear you mind and walk a few flights of stairs? Consistently increasing activity will go a long way in improving your outcomes.

If you are diagnosed with Type 2 diabetes, don’t fret. While it can be overwhelming, we are here to help! Enroll in the Ochsner Digital Medicine program to receive ongoing support that’s catered to you and your needs. Our licensed clinician offers in-depth glucose monitoring and works with your provider to adjust medications and ensure you reach your goals. A panel of professional health coaches support your lifestyle goals, motivating you to improve your diet and physical activity.

The Digital Medicine program focuses on meeting the patient where they want to be met and educating the patient so they can lead their own health journey. This program is an at-home management system, so no extra trips to the doctor’s office are required. Know that there are tools, people, groups and education right here, ready to support you.