Alzheimer's May Be Diabetes of the Brain
The Alzheimer’s Hub of Hope has four sections: Heroes, Highlights, Headlines and Helpers/Caregivers. This post is aligned to the headlines section.
In my previous post, Alzheimer's in the News - November 2023, I commented on an article that discussed how some of the Big Five personality traits can be protective against suffering from AD and other traits were associated with developing AD. In short, high scores on openness to experience, agreeableness, and life satisfaction had a protective effect and high scores for neuroticism correlated with suffering from AD.
I received feedback requesting a link to the Big Five personality Test so that subscribers can better understand their own personality traits. Here’s the link.
During my AD research over the previous year, I often came upon articles, news reports and videos that associate AD with diabetes. I also received a request from subscriber Matt to cover this topic. Apparently, the term “Alzheimer’s is type 3 diabetes” was coined in the 2008 research paper: Alzheimer's Disease Is Type 3 Diabetes–Evidence Reviewed. This rather long and detailed analysis concludes:
Altogether, the results from these studies provide strong evidence in support of the hypothesis that AD represents a form of diabetes mellitus that selectively afflicts the brain.
To be clear, type 3 diabetes is not a true medical diagnosis but a helpful term that allows people to associate what is happening in the brain to what type 2 diabetes does in the rest of the body. I’ve also heard type 3 diabetes referred to as diabetes of the brain.
If AD is a type of diabetes, we should know what diabetes is. The CDC1 defines it as:
Diabetes is a chronic (long-lasting) health condition that affects how your body turns food into energy.
Your body breaks down most of the food you eat into sugar (glucose) and releases it into your bloodstream. When your blood sugar goes up, it signals your pancreas to release insulin. Insulin acts like a key to let the blood sugar into your body’s cells for use as energy.
With diabetes, your body doesn’t make enough insulin or can’t use it as well (insulin resistance) as it should. When there isn’t enough insulin or cells stop responding to insulin, too much blood sugar stays in your bloodstream. Over time, that can cause serious health problems, such as heart disease, vision loss, and kidney disease.
A 2022 press release from the Keck School of Medicine of USC2, identified the strong correlation between a type 2 diabetic and developing AD.
Up to 81 percent of people living with Alzheimer’s are estimated to have type 2 diabetes.
Per their research the earlier a person becomes type 2 diabetic the more likely they are to develop AD.
Type 3 diabetes occurs when neurons in the brain become unable to respond to insulin, which is essential for basic tasks, including memory and learning. Some researchers believe insulin deficiency is central to the cognitive decline of Alzheimer’s disease.3 The brain’s inability to respond to insulin is called “insulin resistance” and results in brain cells “resisting” the body’s attempt to move energy from glucose into the brain. The brain cells are starved for energy which causes the symptoms of AD. When the brain doesn’t get enough energy, it alters its metabolism and leads to cellular damage4. Insulin resistance has been observed in 100% of brains with AD5.
In 2022, the Alzheimer’s Association published research6, using ketones as an alternative fuel for the brain in what they termed “brain energy rescue”. In this randomized, placebo-controlled trial (e.g. high quality, not based on survey data) they saw that all five cognitive domains (Episodic memory, Executive function, Language, Processing speed and Attention ) improved significantly. They concluded:
Improved cognition correlating positively with improved brain energy supply by ketones suggests a direct link to brain energy status. The moderate effect size of this kMCT intervention indicates a clinically meaningful benefit on certain cognitive outcomes, some of which relate directly to risk of MCI progressing to AD.
The “moderate intervention” in the conclusion above is note worthy. The cognitive improvements were the results of participants supplementing with 15g kMCT twice/day. (MCT induces ketones and stands for medium chain triglycerides and can be purchased at any health food store. Ketones can be used by the brain for energy as an alternative to glucose).
WOW! It’s possible to improve cognition simply by taking inexpensive supplements twice a day.
The chart below was copied from the Alzheimer’s Association research and visually describes how intervening with ketones “MCT: (called brain energy rescue on the chart) can benefit AD suffers early on and later in the progression of the disease.
In summary, when the brain can’t get its energy from glucose because of insulin resistance, it can get energy from ketones. When the brain has enough energy the development and/or progression of AD may be prevented. So what is a ketone?
Ketones are a type of chemical that your liver produces when it breaks down fats. Your body uses ketones for energy typically during fasting, long periods of exercise, or when you don’t have many carbohydrates7.
Your body produces ketones from both fats inside the body (e.g. during fasting) and external to the body when consuming fats in foods. You can also digest ketones from ketone ester supplements and MCT oils. The state of using fats (ketones) for energy versus glucose is called ketosis8. Ways to get into ketosis include:
Significantly reducing carbohydrate intake
Intermittent Fasting
Increasing fat intake
Consuming more MCT oil
Increasing physical activity
This 21 minute video from Dr. Mark Hyman, an Alzheimer’s Hub of Hope Hero, explains the association among sugar, diabetes and AD much better than my attempt to describe it above. He discusses a few items I didn’t see in my investigation of the topic, so I bullet pointed them below in case you are not going to watch the full video.
there are many causes of AD but poor metabolic health (insulin resistance) is a major one
the bad news is sugar, starch and carbs drives diabetes of the brain
sugar should be treated like a recreational drug
diabetics have a 400% increase risk of developing AD
you don’t need full blown diabetes to have memory loss
control of blood sugar will help brain problems
a high fat, low glycemic diet is helpful
My Thoughts
I’m happy to see that there seems to be more and more attention to upstream root causes of AD such as insulin resistance and diabetes. These causes may likely result in the amyloid plaques that develop over decades. Take a look at the reference materials below. Once I started researching the diabetes / AD connection I found an abundance of reference materials.
The simple takeaway is don’t get diabetes. This may be easier for some than for others but many believe it is a lifestyle induced illness. You may want to discuss how to do this with your doctor or do the research yourself. The most interesting information to me from reviewing all of the research material is Dr. Hyman’s comments to treat sugar as a recreational drug. I take this as only consume it on occasion. That may be the ideal but in practice reducing it may be more realistic.
If AD is truly diabetes of the brain, then diabetes drugs such as metformin may be helpful in treating the disease. Some of the reference materials below discuss research in this area.
If you are diabetic or pre-diabetic and are looking for a medical practitioner you may want to checkout Virta Health here. They are an online facility with the mission to cure the country’s diabetes epidemic. That’s all they do. The are experts in diabetes prevention and reversal and have doctors, health coaches and an approach personalized for the individual.
Reference Articles Used to Create the Post
Many of these articles contain interesting information that I didn’t include in the post. You may want to read them to get deeper into the details and evidence for how AD and diabetes are linked.
Does Sugar Fuel Alzheimer’s? Brain Glucose Linked to Memory Loss
New Evidence That Diabetes Drugs Could Help Alzheimer’s Patients, Too
Which Is a Better ‘Fuel for the Brain’: Ketones or Sugar?
What is the link between Alzheimer’s and Type 3 diabetes?
Glucose Levels and Risk of Dementia
Type 3 Diabetes: Understanding the Link Between Blood Sugar and Alzheimer's Disease
Is There A Type 3 Diabetes? The Link to Alzheimer's
Type 3 Diabetes and Alzheimer’s Disease: What You Need to Know
Is Alzheimer's disease a Type 3 Diabetes? A critical appraisal
Higher brain glucose levels may mean more severe Alzheimer’s
Type 3 Diabetes and Its Role Implications in Alzheimer’s Disease
The association of diabetes and dementia and possible implications for non-diabetic populations
Videos Used to Create the Post
Many of these videos contain interesting information that I didn’t include in the post. You may want to watch them to get deeper into the details and evidence for how AD and diabetes are linked.
Alzheimer's is Now Called Type 3 Diabetes - Is It Aging or Diet? (4 mins)
Why is Alzheimer's called Type 3 diabetes? The Brain Docs (1 min)
Alzheimer's Disease as Type 3 Diabetes (2 mins)
Alzheimer's should be called type 3 Diabetes (5 mins)
Alzheimer's is Now Called Type 3 Diabetes - Is It Aging or Diet? (4 min)
Mayo Clinic Minute: Is Alzheimer's Type 3 diabetes? (1 min)
Alzheimer's - Diabetes of the Brain Caused by Fructose? (26 mins)
"Type 3 diabetes" — could blood-brain barrier breakdown be the cause? | Axel Montagne, Ph.D. (10 mins)
Type 3 Diabetes - Gary Brecka (2 mins)
Books
Max Lugavere and Dr. Mark Hyman on Type 3 Diabetes (8 min video)