Category: Nutrition

Diabetes and Cognitive Decline

Diabetes and Risk for Cognitive Decline

One of the most important concepts described in Grain Brain focuses on the fundamental role of elevated blood sugar as it relates to brain degeneration. We explored in-depth, scientific literature that demonstrates a significant increased risk for developing Alzheimer’s disease or dementia if a person carries a diagnosis of type II diabetes. This relationship was amplified recently by a study in the New England Journal of Medicine that demonstrated significantly increased risk for cognitive decline with mild elevations of blood sugar, well below levels that would indicate diabetes.

In a recent report, published in Clinical Interventions in Aging, Japanese researchers again solidified our knowledge base about the relationship between diabetes and cognitive decline. The report, “Type II Diabetes as a Risk Factor for  Cognitive Impairment: Current Insights“, focuses on not only statistics relating diabetes to cognitive decline, but also the mechanisms by which that happens.

The researchers describe a variety of factors relating type II diabetes to brain dysfunction including impaired neurogenesis which is the process by which we are able to grow new brain cells, specifically in the brains memory center, hippocampus. This is compromised in diabetes.

Blood brain barrier dysfunction is also noted to occur in diabetes. This sets the stage for entry of otherwise excluded proteins and even bacteria into the brain leading to nerve cell damage.

Diabetes is known to enhance inflammation, and inflammation is indeed a cornerstone of Alzheimer’s type dementia.

Hyperglycemia, describes an elevation of blood sugar, which has direct and toxic effects of brain cells, but also indirectly leads to damage by increasing both inflammation as well as free radical activity through the process of protein glycation, meaning proteins binding to sugar.

Insulin resistance also is associated obviously with type II diabetes. Insulin plays an important role as a trophic hormone in the brain meaning important for health and vitality of brain cells. And when the brain becomes insulin resistant with type II diabetes the function of insulin is compromised.

Finally, it is well known that diabetes is associated with compromise of vascular function, throughout the body, and particularly in the brain. Vascular issues are associated with cognitive decline.

So again, a central theme of Grain Brain is to prevent becoming a diabetic at all cost. That means the diet should be one that is exquisitely low in sugar as well as carbohydrates. We emphasize physical activity, and eating a diet high in fiber based upon above ground vegetables.

These lifestyle recommendations fundamentally focus on regulation of blood sugar which this report clearly supports as playing a critical role in brain preservation.

For more information, order your copy of Grain Brain today and join Dr. Perlmutter’s email list.

  • Ri

    Excellent ! so informative Dr Perlmutter -do you have any information regarding the relation between gluten/carbs and and crohns disease and how to prevent it and/or manage it diagnosed with it?Thank you

    • David Perlmutter

      Might take a look at Wheat Belly by Dr. William Davis

      • Lynn Dell

        Neat! Here is an anecdote on the subject from Dr. Davis’ blog: http://www.wheatbellyblog.com/2013/06/seeing-is-believing/

        Oh, btw, Dr. Perlmutter, I am LoveOH who posted about Daniel Tammet on your Twitter account. I really need to put my name up, but I hardly use the account and don’t mess with settings much. I listened to his brief lecture three times yesterday and once today, and it still seems like it takes one minute to hear it. Thanks so much again for pointing him out some months ago.

        • David Perlmutter

          Oh, great to know Lynn!

  • Lynn Dell

    That’s a deceptively pretty picture at the top of your post, Dr.
    Perlmutter, and for once it’s night time and your picture makes me
    nauseated and not tempted! I overdid it on carbs and gluten earlier today. Gluten is a bad mother. It definitely accentuates the negative and eliminates the positive. I was slapped and smacked down with a reminder of what this poison does. It preys on my weaknesses and makes me want more of it. Ugh! The only redeeming thing is it was earlier in the day, and not in the evening,
    and nobody but me and God knows how it affected me. Blah! I feel bad for people with emotional disregulation issues. You can thank God I don’t, but if I ruled the world I would put everybody who suffers from diagnoses such as borderline personality or ocd or schizophrenia or bipolar on a lower carb, gluten free diet.

  • Michelle

    Dr Perlmutter, you always mention Type II diabetes… Have there been studies on those with Type I? I imagine the same processes would occur? Thanks.

  • Sue Smith

    My aunt had diabetes II for a long time, she was taking insulin pills and the needle. She didn’t really watch her diet so I wasn’t surprised when she went downhill. She eventually was diagnosed with dementia and lived her life out in asssisted living.

    • Carol

      I have a head tremor where my head turns to the left when I lay down to sleep. Can this diet help this?

  • Audrey Savary

    My husband has been diagnosed with type II diabetes and is supposed to be watching his carb counts. We have two adult daughters who have celiac disease and are on a gluten-free diet. We have noticed that gluten-free products are higher in carbs than wheat products so are not good for my husband. I would love to do more gluten-free but do not want to spend the whole day in the kitchen fixing his and her meals. Any solutions I can use?

    • RN

      Go to https://www.wheatfreemarket.com/ and you’ll find wheat free baking mixes which are also low carb.

    • VicLmech

      Gluten-free processed foods are high in carbs. You can choose to use real whole foods that are gluten free. Meats, seafood, eggs, dairy, vegetables, fruits, fermented foods. Stay away from the packaged foods and you will be fine.

      • David Perlmutter

        As I always say, if there has to be a gluten-free version of it, it should be avoided in the first place.

  • Tammy Jo

    Dr. Perlmutter, my heart sinks when I read that the central theme of Grain Brain is to prevent becoming a diabetic at all. You see, I already have it! What about us already type 2 diabetics that have found out this information a little too late, but are changing our lifestyle and food plan, heading in the right direction. Is it too late for us? I have been following Dr. Hyman’s Blood Sugar Solution and 10-day Detox diet since March and have seen some incredible changes in the way I feel and look My A1C has dropped from 7 to 6.2 and I am still a work in progress, but loving how clear-headed and energetic i feel. My body aches are gone, I am sleeping well, my digestive issues are a thing of the past. I feel so good. Please tell me that it’s not too late for me to prevent some of the inevitable, horrible things associated with Type 2 diabetes. I am looking very forward to reading your book, as I have just recently been introduced to you via the internet. Thank you for your insight.

    • David Perlmutter

      Yes, there is hope Tammy Jo!

      • Tammy Jo

        Please tell me more. I need hope.

      • Carol

        I have a head tremor where my head turns to the left when I lay down to sleep. Can this diet help this?

        • Angela Milne

          Hi Carol
          I see no-one has answered you, so let me try. I’m no expert, but it sounds as if you may have a neurological problem. Have you seen a neurologist? That said, I solved a residual tardive dyskinesia problem by cutting out processed foods and sticking to the kind of diet that Dr Perlmutter recommends. Those foods and drinks with a certain type of caramel colouring in them, like red bull, are especially bad. Hope this helps.

  • Marje Cochren

    I am way past Medicare and continue to work although I have type ll diabeties.
    I became diabetic 27 years ago. I work at keeping my A1C at 6 or below. I work in long term care and cannot get it through to the dietary manager that the residents need fewer carbs, more fiber and protein.

  • Barb

    Just wondering if there is any connection to my gluten sensitivity and
    rheumatoid arthritis diagnosis. I have recently been placed on methotrexate
    and am not comfortable taking such powerful medicine. Would the diet
    be considered an alternative to this type of medicine? Any other suggestions would be greatly appreciated.

    • David Perlmutter

      Check some of the science on my site about that Barb: http://www.drperlmutter.com/learn/studies/?study_search=arthritis

    • jg

      I hope you decided not to try methotrexate. I am diabetic and colitis was the reason for metho. I used itfor 2 months and swear it screwed up more than hormones and brain function. It should not be on the market in my opinion. Low carb ketogenic and fodmap food is the way to go for me. It has improved both medical conditions and cognitive function. I have my brain and life back.

  • Dale Evans

    Dr Pearlmutter, my husband is only 64 and just diagnosed with vascular dimentia. He has diabetes and has had 2 heart attacks in recent years. What can I do to try and help this dreadful condition. I have purchased coconut oil, is there anything you can suggest?

    • David Perlmutter

      Follow the dietary and lifestyle changes I advocate for here, and discuss, with his physician, how these could be implemented.

      • Dale Evans

        Thank you Dr. I am even prepared to take him to see you if you thought it would be worthwhile. We are in Australia.

  • andrew

    do you know anything about insulin resistance building up on a low carb diet. i have been off all sugar and grains for 2 years ind my fasting glucose level has slowly gone up from about 5.3 to 6.3. is this type of IR bad and/or can you do anything to reverse that.

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