Understanding the Connection Between Diabetes and Alzheimer’s
How Effective Glucose Control Can Slow the Progression of Cognitive Impairment
by Jennifer Peterson, DNP, APRN, LMT, FNP-BC
In recent years, a link between type 2 diabetes and Alzheimer’s disease has emerged. Diabetes is a risk factor for cognitive impairment including vascular dementia and Alzheimer’s disease (Cukierman-Yaffe et al., 2009). Approximately 50% of people with type 2 diabetes will develop some type of cognitive impairment. Merely having diabetes increases the risk of developing Alzheimer’s by roughly 65% (Heerema, 2020).
The link between glucose processing and cognitive decline
Like diabetes, Alzheimer’s has some insulin resistance, but effects are localized to the brain instead of affecting the whole body. The brain’s ability to use and metabolize glucose is diminished in Alzheimer’s. Researchers found the decline in glucose processing coincided with, or even preceded, cognitive decline (Heerema, 2020). With impaired glucose processing, it is possible that chronic exposure to high glucose levels accelerates the brain’s cognitive demise. Postmortem studies of senile plaques from those with Alzheimer’s showed byproducts associated with hyperglycemia (Cukierman-Yaffe et al., 2009). The Action to Control Cardiovascular Risk in Diabetes-Memory in Diabetes (ACCORD-MIND) trial determined higher A1C levels are associated with lower cognitive function in persons with diabetes. McIntosh and Nation (2019) determined chronic hyperglycemia is associated with increased tau (a protein in neurons) dysfunction. Individuals with uncontrolled diabetes showed a faster progression to dementia when compared to individuals with controlled diabetes. Some studies show Metformin has neuroprotective effects and GLP-1 agonists are hypothesized to have the same.
Nevertheless, if diabetes exacerbates the risk and contributes to the development of Alzheimer’s disease, then proper management of diabetes is of utmost importance. Preventative care needs early detection then control of both diabetes and cognitive impairment (Sridhar, Lakshmi, & Nagamani, 2015). GlyCare provides comprehensive glycemic management in hospitals, bridge clinics, and virtually outpatient.
How Glycare can help manage glucose control
GlyCare is a team of dedicated, endocrinologist trained and supervised, diabetes mid-level providers who care for patients’ glycemic abnormalities. They work in conjunction with physicians, nurses, and staff to ensure proper blood glucose management. The team can expedite glucose control and subsequently ensure it stays within goal range. Patients with diabetes need proper support, guidance, and safe medication planning to delay or halt the progression of cognitive impairment.
About the author
Dr. Jennifer Peterson, Nurse Practitioner, is the Director of Quality Assurance and Integration for GlyCare. She has years of experience managing diabetes for patients in the hospital and now trains other nurse practitioners to do the same. Dr. Peterson also ensures GlyCare provides high quality services for all patients through a quality review program she created.
References
Cukierman-Yaffe, T., Gerstein, H., Williamson, J., Lazar, R., Lovato, L., Miller, M., Coker, L., et al. (2009). Relationship between baseline glycemic control and cognitive function in individuals with type 2 diabetes and other cardiovascular risk factors: The action to control cardiovascular risk in diabetes-memory in diabetes (ACCORD-MIND)trial. Diabetes Care 32(2), 221-226.
Heerema, E. (2020, February 8). Why Alzheimer’s disease is called type 3 diabetes.
McIntosh, E. & Nation, D. (2019). Importance of treatment status in links between type 2 diabetes and Alzheimer disease. Diabetes Care.
Sridhar, G., Lakshmi, G., Nagamani, G. (2015). Emerging links between type 2 diabetes and Alzheimer’s disease. World Journal of Diabetes 6(5), 744-751.
Learn more about partnering with GlyCare for a turn-key diabetes management service. For more information on how to incorporate either in-person or virtual diabetes management, contact us today.