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Published on July 27, 2021

One more important reason to get blood sugar under control

Blood Sugar Concerns

Need more incentive to get your type 2 diabetes under control or avoid it altogether? According to a new survey of 10,000 people in the United Kingdom, the longer you live with diabetes the more likely you are to develop dementia.

Researchers looked at 30 years of data that started when subjects were ages 35 to 55, according to a report published in April in the Journal of the American Medical Association. Those who had been diagnosed with diabetes by age 60 were more than twice as likely to develop dementia by the time they turned 70. And, the risk for having dementia at 70 rose 24 percent for every five years patients had been diagnosed with diabetes. The survey did not address the effect of diabetes treatment on dementia risk but did include those who were taking medication.

The results are particularly concerning given the growing number of people who develop type 2 diabetes before age 35, said Sheila Maier, DO, an endocrinologist at the Endocrine Center of Cape Cod in Hyannis.

“We are seeing type 2 diabetes in a lot more people, largely related to the obesity epidemic,” she said. “People can be diagnosed with type 2 diabetes as children or teens, which means potentially they have decades of blood sugar problems. That raises the risk not just of dementia, but also the other vascular problems, kidney disease, nerve damage and all the other negative things that we associate with type 2 diabetes.”

About 1 in 10 Americans have diabetes and more than 90 percent of those cases are type 2, according to the U.S. Centers for Disease Control and Prevention. The percentage of the population diagnosed with diabetes grew tenfold between 1958 and 2017, according to the CDC.

People with type 2 diabetes don’t respond normally to insulin. Because of this insulin resistance, their pancreas makes more insulin in an attempt to get cells to respond. But, eventually the pancreas can’t keep up, and blood sugar rises, according to the CDC.

It’s not entirely clear how diabetes is connected to dementia. The insulin imbalance may affect the brain chemically, while high blood sugar causes inflammation that damages blood vessels, according to the Alzheimer’s Association. Also, diabetes raises the risk of heart disease and stroke, damaging blood vessels, including those in the brain that could contribute to cognitive decline, the association says.

While genetics plays a part, type 2 diabetes is strongly correlated with excess weight and obesity, said Dr. Maier.

“The flip side of that is that we also have really good data to show that when people lose weight, it significantly improves the risk of developing diabetes and improves blood pressure and cholesterol and reduces heart disease,” she said. A number of studies have shown that for many people losing 5 to 7 percent of body weight improves health and conditions such as diabetes and heart disease, she said.

If you’re ready to work on weight, try to avoid fad diets, she said.

“You want to have a diet that’s got a diversity of nutrients, fruits and vegetables, and it’s got to be something you’re going to be able to stick to. If it’s highly restrictive, then it’s not going to be a long-term solution.”

If you need help, talk to your doctor about newer medications that might help with weight loss, she said. One is dulaglutide, which is actually a diabetes medication that alters glucose metabolism in the liver and has been shown to help with weight loss, she said. Also, programs like the Cape Cod YMCA’s Diabetes Center offer diabetes education and help with making lifestyle changes. Ask about diabetes education programs at community centers and councils on aging, as well.

“The important thing for the average person to realize is that if they have diabetes, and they’re worried about the risk of dementia, the best thing they can do is keep their blood sugar under control, whether that’s with diet, exercise or medications,” Dr. Maier said. “Exercise and weight loss are also key components to staying fit and staying mentally active, too.”