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Tue, Jan. 21

Possible connections between diabetes, dementia

If you have diabetes, there are many reasons to keep blood sugar levels within healthy goals. Good blood sugar control protects your vascular and nervous systems, and vital organs like your kidneys and eyes, thus preventing heart disease, stroke, neuropathy (nerve damage), kidney failure and blindness. Furthermore, some recent studies suggest that maintaining healthy blood sugar levels may also reduce the risk of dementia - the loss of memory and thinking skills that affects millions of Americans as they age, but doubt about this connection still remains.

A large, four-year study of individuals aged 65 or older in France found that participants with diabetes had a greater risk of developing dementia than those without diabetes. High triglyceride levels, a fat found in blood, also predicted risk.

Diabetes has been linked to dementia in a number of other studies as well. In a 2006 review published in The Lancet Neurology, scientists comparing the results of 14 different studies found that about half the studies reported a higher risk of "any dementia," including Alzheimer's disease (AD), in individuals with diabetes compared to healthy controls.

More recently, researchers in Washington State tracked the blood sugar levels of over 2,000 people for nearly seven years and found a steadily increasing risk of dementia with increasing blood sugar. This relationship occurred even with individuals without diabetes and among those with blood sugar levels considered normal (though on the high end of normal).

Other studies, however, have found no connection between diabetes and dementia. The Framingham Heart Study, a project of the National Heart, Blood and Lung Institute and Boston University, has been tracking the cardiovascular health of individuals living in Framingham, Mass., every two years since 1948. One group of Framingham participants has been followed for about 13 years as part of an additional study to learn more about the causes of AD and dementia. In a recent analysis of data, researchers found no connection between blood insulin (often elevated in pre-diabetes) or higher-than-normal glucose levels and dementia or AD.

Though there may be a link between elevated blood sugar levels and dementia, scientists are far from being sure if and how diabetes increases risk. They do know that the brain is a big consumer of glucose and that the brain might just be another organ, like the kidneys and eyes, that is susceptible to damage from higher-than-normal glucose levels in the blood.

If a connection be-tween diabetes and dementia exists, it would serve as one more good reason to adopt lifestyle habits that keep blood glucose levels in good control. According to Kim Friend, R.N., C.D.E., a diabetes educator with the YRMC Department of Preventive Medicine, diet, exercise, stress management and medications all play a role in treating diabetes and preventing complications of the disease. "I encourage patients to remember meals, meds, motion and stress management for diabetes management and diabetes prevention," Friend said. "Fill half of your plate with low-carbohydrate vegetables and choose low-fat proteins and high fiber starches to complete the meal. Weight loss is one of the keys to preventing and treating diabetes, so adjust your portions to maintain a healthy weight. Get some movement everyday, and practice stress management, like deep breathing, stretching, walking or meditation. Lifestyle change alone can keep blood sugar levels under control. However, most people with diabetes need medication as well."

Diabetes can be a real threat to your health and quality of life. Adopting a healthy lifestyle can help you prevent the disease and, if you have diabetes, avoid many of the complications, possibly including dementia.

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