Did you know that diabetes can increase your risk of dementia? Scientists don’t know exactly why, but there are several possible reasons. For example, high sugar levels in the blood can damage blood vessels, including those in the brain. Damage to blood vessels can reduce blood flow and lead to nerve damage, which can lead to various forms of dementia.
There is also evidence that the younger you are when you are diagnosed with type 2 diabetes, the greater your risk of dementia. For example, one study we previously reported showed that being diagnosed with type 2 diabetes before age 60 increased the risk of dementia by 300%. People diagnosed with type 2 between the ages of 60 and 69 had a 73% higher risk of dementia, and people diagnosed with type 2 between the ages of 70 and 79 had a 23% higher risk of dementia. Ta.
However, new research shows that it may reduce the risk of dementia in people with type 2 diabetes.
How was the study conducted?
The large cohort longitudinal study was published on February 12, 2024. JAMA network opencompared people with diabetes who voluntarily participated in a public health program called Risk Assessment and Management Program-Diabetes (RAMP-DM) to people with diabetes who did not participate in the program.
A total of 55,618 people with an average age of 68 years participated in the study. Each person had had diabetes for an average of about 6 years. Data was extracted from his medical records spanning eight years from 2011 to 2019.
The RAMP-DM group received multidisciplinary care that included a team of healthcare providers. The other group served as a control group and received “usual care.”
Usual care included seeing a primary care physician (PCP) every 2 to 4 months. PCPs performed physical examinations, prescribed and adjusted medications, and referred these patients to specialists as needed.
In addition to usual care, the RAMP-DM group received many other benefits. Their care teams included allied health professionals, including physicians, nurses, and registered dietitians. Participants in this group underwent assessment of lifestyle behaviors and medication adherence, screening for diabetic complications, and estimation of cardiovascular risk. They also received health education and general guidance on diabetes management.
Risk factors for which the RAMP-DM group was screened included smoking status, obesity, high blood pressure, high cholesterol and high triglycerides, diabetic retinopathy (an eye disease that causes vision loss or blindness), and albuminuria (proteins in the urine). ) is included. signs of kidney disease), foot problems, and estimated glomerular filtration rate (a measure of kidney function).
Participants in the RAMP-DM group were referred to a specialist if risk factors were found. This group was also stratified into different risk levels based on risk factors and their HbA1c (90-day average of blood sugar levels). Participants who were considered at high risk with HbA1c levels of 7% or higher received more intensive interventions and more frequent follow-up with their medical team.
To increase the validity of the study, the researchers excluded people whose dementia was diagnosed as a result of alcohol, drugs, or infectious diseases when evaluating the data. Typical baseline data such as age, gender, BMI, cholesterol and triglyceride levels, blood pressure, fasting blood glucose, and medications were also collected. Participants with missing baseline data were also excluded.
After performing several statistical analyzes on the data, the researchers found that the RAMP-DM group had a slightly higher risk of dementia compared to people without diabetes, but compared to the usual care group. In comparison, we determined that patients in the RAMP-DM group had a 28% risk of dementia. Lower risk of developing all-cause dementia, 15% lower risk of Alzheimer’s disease, 39% lower risk of vascular dementia, and 29% lower risk of other dementias or unspecified dementia.
Further statistical analysis suggested that HbA1c levels above 7.5% increased the risk of dementia.
Interestingly, there was also an association between HbA1c levels below 6.5% and dementia. The researchers explained that the “healthy” target HbA1c range in this study was 6.5% to 7.5%. Levels below 6.5% suggest frequent occurrence of hypoglycemia (low blood sugar) and poor blood sugar control.
This suggests that poor glycemic control is a link between type 2 diabetes and dementia.
How does this apply to real life?
A diabetic’s main goal is to maintain stable blood sugar levels. This is easier said than done, but it is certainly achievable. It is important to try to keep your blood sugar levels stable. Because when your blood sugar levels aren’t stable (think big spikes and dips), they can damage your body’s tissues over time and increase your risk of a variety of diseases, including heart disease, dementia, and blindness. is. and loss of limbs.
In this study, the RAMP-DM group had a lower risk of dementia, in part because they had more tools at their disposal to manage their blood sugar levels than the control group. You can use these same tools.
If your health care provider hasn’t referred you to another professional, such as a registered dietitian or certified diabetes educator, ask for one. It’s also a good idea to include a cardiologist and an ophthalmologist on your medical team for heart and eye health. Also, ask for a referral to an endocrinologist if you are dissatisfied with the treatment your health care provider is giving you. Endocrinologists specialize in diabetes treatment.
If you are prescribed medication, take it as prescribed. Check your blood sugar levels as often as your health care team recommends, and start noticing how you’re feeling in relation to your numbers. This helps connect the dots between high and low blood sugar moods.
If you have diabetes, you need to be especially careful about your diet. There are many myths about food and diabetes, especially carbohydrates, so be sure to work with a registered dietitian or certified diabetes educator to get factual information.
Other lifestyle factors that affect blood sugar levels include exercise, stress, and sleep. Even when you are dehydrated, your blood sugar levels will rise.
This may sound like a lot, but it doesn’t have to be if you take it literally one step at a time. There is evidence that walking for just two minutes after a meal can help lower blood sugar levels.
conclusion
Managing blood sugar levels is one important piece of the puzzle in protecting the brain and reducing the risk of dementia. If you feel you are showing signs of cognitive decline, especially if others have noticed your mental deficiencies, talk to your health care provider about it.
You may need to become your own advocate when it comes to diabetes treatment. Think of yourself as the CEO of your body and build a team of experts who can help you achieve your goal of safely managing your blood sugar levels. Note that missing readings from time to time will not affect your HbA1c level. HbA1c shows frequent highs and lows, so it’s important to consistently manage your blood sugar levels.
Like any other lifestyle change, managing diabetes can be broken down into the behaviors that affect it. Start where you are now and gradually change those areas. You can also rely on your diabetes care team for advice and support.
