Amid the global trends of aging populations and decreasing birthrates, the number of people living with chronic illnesses is rising, especially those with diabetes and dementia, and studies have shown there might be a link between the two.
The number of dementia cases worldwide last year increased by 10 million, and is expected to reach 150 million by 2050, Alzheimer’s Disease International’s latest data showed.
In Taiwan, there are 3.4 million people aged 65 or older, among which 280,000 have dementia, meaning that there is one dementia case for every 84 Taiwanese, Taiwan Alzheimer’s Disease Association data showed.
The association forecast that in the next 47 years, the number of people who develop dementia would average 36 per day, or one every 40 minutes.
Linkou Chang Gung Memorial Hospital physician Lin Chia-hung (林嘉鴻) said that a direct cause of dementia had not yet been identified, but a growing number of studies have suggested a link between dementia and diabetes.
That is why “type 3 diabetes” has become a newly proposed term to describe the hypothesis that Alzheimer’s disease — a major cause of dementia — is triggered by a type of insulin resistance and insulin deficiency that occurs specifically in the brain, Lin said.
“Due to medications or dietary habits, diabetes patients often experience low blood sugar, which increases the risk of brain cell damage,” he said.
The reason that dementia is considered “diabetes in the brain” by some people has to do with insulin resistance, Lin said, adding that impaired glucose metabolism in the brain leads to degeneration and dysfunction of brain cells.
As diabetes accelerates atherosclerosis — a hardening of the arteries — a lack of oxygen in the brain can occur, affecting brain functions, he said.
Dementia is not exclusive to old people, as the younger a person is when diagnosed with diabetes, the higher their risk of diabetes complications, especially in patients with poorly controlled blood sugar levels marked by great fluctuations, Lin said, adding that a majority of studies on links between dementia and diabetes concerns type 2 diabetes.
Also a diabetic himself, Lin said he always stresses to his patients the importance of glycemic control, which is practiced by eating foods high in fibers, such as vegetables and fruits, and low in fats, sugars and with a low glycemic-index rating.
Oatmeal and brown rice are better options than refined carbohydrates, such as pork buns, steamed buns and bread, he said, adding that eating three meals at regular times and with consistent amounts also helps.
In addition to medication and maintaining a healthy diet, controlling blood pressure and lipids also helps with lowering the risk of diabetes complications, as well as cross-departmental care in the prevention of the narrowing and hardening of arteries, he said.
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