Diabetes y Alzheimer, did you know?

Professionally, there are some things that I find very striking; I would even say that they annoy me. And that frustrate me. Or something halfway between discomfort and frustration. And it is a question of experience rather than “knowledge.”

One of these things is, for example, to contrast how the general population lives with its back turned to the tsunami that type 2 diabetes represents in the public health panorama. This is not the first time I have commented on it in this corner, and the repetition of my denunciation is perhaps a sign of my frustration.

If you consult the most elementary medical guides and books, you will find incontrovertible data on how the diagnosis of diabetes increases the risk of more than a few chronic complications.

Most of them have their origin in a vascular problem, both when they affect the large arteries and the smaller ones, typically in the retina and the kidney. Thus, in the long term, the most poorly managed cases of diabetes with the worst evolution are likely to lead to diabetic retinopathy, chronic kidney disease, heart disease and even limb amputations. But beyond the “classic” consequences, science is becoming increasingly clear about the links with other health complications that are not unimportant. One of them, which we have already mentioned in this space, is periodontitis (not to mention COVID19); and another, more far-reaching if possible, is Alzheimer’s disease.

Insulin, mitochondria, inflammation and the nervous system 

It is possible that quite a few readers are now having breakfast with this link, they cannot be blamed. In their defense it can be argued that the discovery of this relationship is relatively novel, not unpublished, but certainly recent. In fact, the number of publications dealing with the relationship between two pathological entities was practically insignificant until the 1990s, when annual publications began to skyrocket. So much so that the first study showing a strong association between these two entities dates back to 1999.

diabetes AlzheimerThere are currently more than 6,500 papers indexed in the National Library of Medicine of the United States (PubMed for friends) that address this reality and try to explain the physiological mechanisms that cause them (they are not yet clearly defined). Interest is growing and it is a field under study that is attracting increasing attention.

One of the most recent reviews on this topic begins by stating that both diabetes and obesity are two of the most obvious modifiable risk factors for Alzheimer’s disease (the most common cause of dementia accounting for 60-80% of all cases). It highlights that recent scientific advances indicate that the elderly diabetic population is more susceptible to cognitive decline associated with aging than older people without diabetes.