Avoiding Diabetes Can Help You Avoid Alzheimer’s

Avoiding Diabetes Can Help You
Avoid Alzheimer’s

Insulin resistance and diabetes increase the risk of cognitive impairment—and worse
By Will Block

f good health is a slippery slope, then what makes it so darned slippery is fat, mainly. Being fat (not obese, necessarily, but significantly overweight) is a first-class ticket to all kinds of health problems, ranging from minor to catastrophic. One of the worst is type 2 diabetes, a disease caused by deficient glucose metabolism. That’s bad enough, but it opens a Pandora’s box of nasty complications and still more major diseases, all of which conspire to make that slope steeper and slipperier than ever. And we all know what’s at the bottom of the slope, don’t we?

When President Reagan’s long, slow slide ended in June, it was because of Alzheimer’s disease, as everyone knows. Few people, however, know that the risk for Alzheimer’s is greatly increased in people with diabetes (which Reagan did not have, as far as we know). Strong new evidence for a connection between these two terrible diseases was published in the Archives of Neurology only a few weeks before Reagan died.1 We’ll get to that evidence shortly, after returning for a moment to the slippery slope.

Claw Your Way to Good Health

Everyone is somewhere on that slope, whether they’re aware of it or not. Basically, maintaining your good health—or trying to improve your health if it has suffered—is a matter of clawing at the slope every day, in one way or another, so as not to slide farther down. Because this is literally a matter of life or death, you must use whatever claws you can—no holds barred. The two biggest claws you’ve got, of course—your Twin Claws of Steel—are diet and exercise (and don’t you wish you had a buck for every time you’ve heard that?). But it’s good to remember that you have other claws as well—smaller, more delicate, more subtle claws, yet still potentially powerful against the force of your own weight trying to drag you down.

We’re talking about molecular claws, in the form of nutritional supplements. If you’re carrying around excess fat, as is true of about 60% of the American population, you want to unsheath at least two of these refined claws: one to fight obesity and one to fight (or prevent) its dreadful spawn, diabetes. For example, if overeating is your problem, any supplement that can help suppress your appetite will be valuable.* And if your problem is diabetes, or its ominous precursor, insulin resistance, you need something that can help you gain better control over your blood sugar levels.


*A remarkable appetite suppressant, of ancient origin but new to the Western world, has just become available; see the article “Stifle Hunger with Hoodia on page 4 of this issue.


MHCP—Cinnamon’s Gift to Your Blood Sugar

In the realm of supplements, your best bet for controlling your blood sugar is MHCP (methylhydroxychalcone polymer), a natural compound found in cinnamon. MHCP is an insulin mimetic, i.e., a compound that mimics the effects of insulin, the hormone that regulates blood sugar levels by facilitating glucose metabolism. In a number of animal trials, it has been shown that MHCP stimulates the uptake of glucose by the body’s cells, and it signals muscle and liver cells to convert glucose into glycogen to be stored for later use; both of these actions result in reduced levels of glucose in the blood. (For more on this subject, see “Revitalize Yourself: Cinnamon Extract for Healthy Blood Sugar” in the March 2002 issue.)

Excessive blood sugar—the hallmark of diabetes—is dangerous for many reasons, among which is an impairment of cognitive function, including memory loss. There is mounting evidence, however, that such impairment can occur even with insulin resistance, the age-related, prediabetic condition in which insulin receptors on your cell walls gradually lose their sensitivity to insulin, thus interfering with proper glucose uptake by the cells. To preserve your cognitive health, therefore, it’s vital to avoid insulin resistance – which is associated with cognitive impairment – which leads to diabetes – which means further cognitive impairment – which could lead to dementia – which will both ruin and shorten your life. (See “Controlling Blood Sugar Helps Preserve Cognitive Function” in the March 2004 issue.)

Researchers Recruit Nuns, Priests, and Brothers

Researchers at the Rush University Medical Center in Chicago were interested in a possible connection between type 2 diabetes and Alzheimer’s disease (AD). They knew from previous studies that diabetes is associated with many adverse health effects, including cognitive impairment. Furthermore, some studies had suggested that people with diabetes are at increased risk for AD, whereas other studies had not found this association. To try to resolve this matter, the Rush researchers decided to examine data from the Religious Orders Study, a large, ongoing study of aging and Alzheimer’s disease in Catholic nuns, priests, and brothers.1

All the participants—824 members of religious orders from more than 40 groups throughout the United States—were over 55 (average age 75) when they were enrolled in the study during the period 1994–2003.* All of them agreed to undergo annual clinical evaluations, including tests of various cognitive functions, by physicians participating in the study, and to donate their brains to the research program upon their death.


*The homogeneity of this group of participants was a strength of the study, because it tended to minimize potentially confounding factors, such as differences in occupation and lifestyle. It was also a weakness, however, because the individuals in question do not represent the diversity of the population as a whole.


A Molecular Link Between Diabetes and Alzheimer’s

A neurodegenerative disease is one that is characterized by a progressive impairment in any neuronal function, whether in the central nervous system or the peripheral nervous system. There are more than 100 inherited syndromes of neurodegeneration, and of these, about 30 are associated with diabetes, insulin resistance, and obesity.1 That’s the bad news. The good news (in a manner of speaking) is that, almost invariably, it’s the neurodegenerative disorder that appears to cause these conditions, not vice versa.

So if you’re overweight or have insulin resistance or diabetes, you don’t have to worry about falling victim to most of those neurodegenerative disorders. But there’s one exception, and it’s a big one: Alzheimer’s disease, which is by far the most common form of dementia, and the most common neurodegenerative disease of any kind. As discussed in the accompanying article, having diabetes apparently increases your risk for Alzheimer’s. But there’s more: it turns out that having Alzheimer’s seems to predispose you to insulin resistance and diabetes—so it cuts both ways!1

There’s a biochemical link between the two diseases, in the guise of amyloid, a small protein molecule, or polypeptide, that occurs in a number of related forms. One of them, amyloid-beta, constitutes the bulk of the destructive plaques that are one of the neuropathological hallmarks of Alzheimer’s. Another amyloid, called islet amyloid polypeptide, is commonly observed in diabetes patients—not in the brain, but in the pancreas—specifically, in the cell clusters (called the islets of Langerhans) from which insulin is secreted. How’s that for a “coincidence”?*


*Amyloid deposits are also found in the brains of patients with Parkinson’s disease (the second most common neurodegenerative disease) and in older individuals with Down’s syndrome. These are among the roughly 30 neurodegenerative disorders that predispose their victims to insulin resistance or diabetes (and, in many cases, obesity).


These two forms of amyloid have a 90% similarity in their molecular structures. Depending on exactly where the 10% of differences lie on their polypeptide chains, the molecules could be very similar or very different in terms of biological activity. Regardless, the very fact that two such similar proteins of the same family are found in both diabetes and Alzheimer’s suggests that these diseases are indeed related—a very sobering thought, and one that should make all adults want to redouble their efforts to avoid both of them.

Reference

  1. Ristow M. Neurodegenerative disorders associated with diabetes mellitus. J Molec Med 2004 Jun 3;published online

How Brains Speak from the Beyond

The reason for the requirement of brain donation is that postmortem examination of the brain of a dementia patient is the surest way to make a diagnosis of the type of dementia (whether Alzheimer’s disease or some other type, such as vascular dementia or dementia with Lewy bodies) and to determine the exact nature and extent of the brain damage. By correlating this information with data on the specific nature and extent of the cognitive deficits and behavioral problems exhibited by the patient before he or she died, researchers can obtain an ever clearer picture of how the various types of dementia affect cognitive functions and behavior.

Such information is of great value to practicing physicians, who must base their diagnoses primarily on the clinical symptoms they see in their patients (or hear about from the patients or their caregivers). The earlier and the more accurately the diagnosis can be made, the better able the doctor will be to prescribe the most appropriate therapy.

Diabetes Increases the Risk for Alzheimer’s

Depending on when they enrolled, the participants in the Religious Orders Study had undergone anywhere from 2 to 10 annual evaluations (average: 5.5) when the Rush researchers completed their analysis of the data acquired up to that point. The cognitive function tests—19 tests in five categories—were chosen so as to assess a broad range of abilities that are commonly affected by aging and Alzheimer’s disease. (The five categories were episodic memory, semantic memory, working memory, perceptual speed, and visuospatial ability.) The results of all 19 tests were analyzed individually but were also combined into one summary measure of global cognitive function. All the analyses were adjusted to account for differences in age, sex, and educational level of the participants.

Of the 824 participants, 91 (11%) had diabetes at baseline (i.e., when they enrolled), and the disease was present in 127 (15%) of them sometime during the study period. None of them had clinical signs of dementia of any kind at baseline. In the follow-up evaluations, however, 151 of the participants had developed Alzheimer’s disease, and of these, 31 had diabetes. According to the known statistics regarding the incidences of diabetes and AD, this meant that there was a 65% increase in the risk of developing AD in those with diabetes compared with those without diabetes—a stunning result.

Because an increased risk for stroke is associated with both diabetes and dementia, and because 132 (16%) of the participants experienced one or more strokes, the researchers crunched the numbers all over again, taking account of this additional factor to see whether it would make a substantial difference in the outcome. It did not: the risk for AD was found to be 58% greater, so the basic conclusion that diabetes appears to be a major risk factor for AD in old age remained intact.

Diabetes May Affect Cognitive Functions Differently

When the researchers examined the data regarding the global measure of cognitive function, they found that the participants with diabetes had lower baseline scores than those without diabetes, indicating a general decline in cognitive function associated with the disease—no surprise there. Over time, the rate of cognitive decline in those with diabetes was somewhat greater than the rate in those without the disease, but not significantly so.

When the researchers looked at the data for the tests of cognitive function in the five categories mentioned above, however, it turned out that there was a greater rate of decline in one category (perceptual speed) in the participants with diabetes—the rate was 44% greater, in fact. (A further analysis showed no evidence that stroke modified the impact of diabetes on the rate of decline.) This suggests that diabetes may be related to a decline in some cognitive systems but not in others, or to different degrees in different systems.

Protecting Yourself Is Not That Hard

It is estimated that about 25–30% of Americans are obese, and about 60% are overweight or obese—a terrible indictment of our overfed, underexercised lifestyle. No wonder insulin resistance and diabetes are epidemic, and no wonder the incidence of Alzheimer’s disease is climbing as well. But isn’t it gratifying to know how easy it is, relatively speaking, to reduce your risk dramatically? Don’t be fat! Maintain good control of your blood sugar levels, perhaps with the help of a natural supplement such as MHCP. Do that, and the slippery slope will tilt in favor of a long and healthy life for you.

Reference

  1. Arvanitakis Z, Wilson RS, Bienias JL, Evans DA, Bennett DA. Diabetes mellitus and risk of Alzheimer disease and decline in cognitive function. Arch Neurol 2004 May;61:661-6.

Caution: If you have diabetes, do not take any supplement that may affect your blood sugar levels without first consulting your physician. Diabetes is a serious disease requiring careful professional management.


Will Block is the publisher and editorial director of Life Enhancement magazine.

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