We have known for some time that diabetes is associated with increased risk of neurodegenerative disease. A meta-analysis published in 2013 reported a 73% increased risk in all-type dementia in diabetes patients. The brains of dementia sufferers can have impaired glucose metabolism, and some have speculated that Alzheimer’s disease may result from brain-specific insulin resistance.
There is some evidence that altered glucose meatabolism may play a causative role in dementia, such as a study reporting that diabetes treatment leads to lower levels of tau protein in the cerebrospinal fluid.
Clinical trials investigating the benefits of diabetes drugs in nondiabetics with Alzheimer’s disease have been mixed, but some treatments do show promise. Nasal insulin, for example, appears to slow progression of the disease, while some studies suggest metformin may also be beneficial, although this has been controvertial.
With confidence in the amyloid theory of Alzheimer’s shaken by the recent failure of several plaque-targeting drugs, finding alternative avenues of research has become increasingly pressing. Drugs and lifestyle interventions aimed at the metabolism may provide such an opportunity.
Diabetes mellitus and risk of dementia: A meta‐analysis of prospective observational studies: https://doi.org/10.1111/jdi.12087
The starving brain: Overfed meets undernourished in the pathology of mild cognitive impairment (MCI) and Alzheimer's disease (AD): doi: 10.1016/j.neuint.2017.09.004
Importance of Treatment Status in Links Between Type 2 Diabetes and Alzheimer’s Disease: https://doi.org/10.2337/dc18-1399
Cognitive vitality: https://www.alzdiscovery.org/cognitive-vitality/ratings/metformin
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