What exactly is diabetes, and what does it have to do with brain health and dementia risk? Here's why the two diseases are so closely interconnected, along with science-backed strategies to prevent them both.
More than one in four adults over the age of 65 develops diabetes. This condition damages the pancreas, making it hard for the body to control blood sugar. Because blood sugar plays a key role in powering the brain, diabetes and brain health issues, including Alzheimer’s and other forms of dementia, have some serious overlap. In fact, people living with diabetes have a notably higher chance of developing Alzheimer’s — some studies say their risk increases by some 65 percent.
They are so closely linked, in fact, some researchers have even dubbed Alzheimer’s “Type 3 diabetes.”
What is diabetes?
Diabetes is the umbrella term for a group of similar chronic diseases that result in too much sugar — also called glucose — in the blood.
Type 2 diabetes is a condition that affects the way the body processes glucose in the blood. In Type 1 diabetes, the pancreas produces little or no insulin.
In short, if you have diabetes, your body is having trouble turning food into energy. Your body breaks down most of the food you eat into glucose which makes its way into your blood, traveling around your body and delivering energy — including to your brain. The pancreas plays a role in this fuel system, too. It produces a hormone called insulin, which helps make sure the levels of glucose in your bloodstream don’t get too high.
What does blood sugar have to do with brain health?
Sugar is the main source of fuel for the brain. If there’s a problem with the delivery system, and the brain isn’t getting the right amount of glucose — possibly due to an issue with the ability of the pancreas to produce insulin — the brain starts to slow down as it runs out of fuel, and that leads to fatigue, brain fog, and problems with memory.
These cognitive issues can be short-term, but scientists are looking into the long-term effects of this breakdown on the brain, too.
Diabetes has been found to lead to permanent cellular damage in the brain, and this, researchers say, might be the reason why it, in turn increases a person’s chances of developing dementia in their lifetime or experiences dementia earlier than they would have otherwise by as much as double.
If you’re at risk of diabetes, you might also be at risk of Alzheimer’s, thanks to this genetic variant
The APOE gene is the human body’s instruction manual for building apolipoprotein, a protein that grabs and carries cholesterol throughout the body. Everyone carries two copies of this gene — and it comes in a few variants. One of these variants, APOE4, has been found to increase a person’s chances of developing cardiovascular disease — and Alzheimer’s disease.
People carrying one or two copies of this gene are worse at clearing disease-causing beta-amyloid plaques in the brain, making them more susceptible to Alzheimer’s. Interestingly, APOE4 is a risk factor for diabetes, too. People who carry this genetic variant are more likely to have issues with the pancreas’s ability to produce insulin and regulate blood sugar.
So, how do you prevent both diabetes and dementia?
With so many shared risk factors between the two diseases, there is some good news. Many diabetes prevention strategies also reduce the risk of developing dementia.
1. A heart-healthy diet
A healthy Mediterranean or MIND-style diet reduces cholesterol and blood sugar. Some research suggests that these diets also lower the risk of dementia. These two similar diets consist of foods like:
- Fruits, vegetables, and legumes
- Nuts and seeds
- Whole grains
- Seafood
- Olive oil
2. Regular exercise
Physical exercise, which lowers blood sugar as the body mobilizes it to fuel the muscles, has also been shown to both reduce dementia risk and help prevent diabetes.
3. Keeping your blood sugar in check.
See your doctor regularly and keep track of the answer to this question: Are you pre-diabetic? Showing just how strong this link between brain health and blood sugar is, drug developers are testing drugs originally designed for diabetes as a potential treatment for Alzheimer’s. Diabetes and weight-loss drug semaglutide (brand names Ozempic, Wegovy) is being tested as a way slow the progression of cognitive decline in Alzheimer’s.
If you already have diabetes, medications that bring blood glucose under control, like metformin, have been found to lower Alzheimer’s risk.
Combining lifestyle-based prevention strategies with new drugs that address these health conditions’ overlapping factors could bring us closer to helping people avoid both diabetes and dementia.
I appreciate your articles that are so clearly written. I have type 2 diabetes, and my mother had it also. She also had Alzheimer’s and hid it for many years. Instead of asking for help, she denied it until it became obvious to everyone. She died from it in 2021, after being in a nursing memory unit at age 93.
My sister and I are noticing signs of memory loss. We’re in early 70’s and we’re both pretty worried. Mostly because the diagnosis is still post-mortem. We have changed our diets, and try to get exercise but at our age it gets more difficult. I’ll keep waiting for new information if I can remember to read it 😳😵💫
Hi Heidi, thank you for being here. It’s understandable to feel concerned, given your family history. The lifestyle changes you and your sister have made—improving your diet and staying active—are great steps toward supporting brain health. Here’s a great article on the science behind exercise and brain health: https://www.beingpatient.com/exercise-brain-health-aine-kelly/?utm_source=organic&utm_medium=social