Type 2 Diabetes and Cognitive Decline: What You Need to Know

Type 2 diabetes is a condition that affects millions of people worldwide, yet its implications extend far beyond the well-known complications like heart disease and nerve damage. Emerging research has revealed a concerning connection between Type 2 diabetes and an increased risk of Alzheimer’s disease and other cognitive impairments. A recent study led by Umeå University in Sweden sheds light on a potential reason for this link, offering crucial insights into the relationship between high blood sugar levels and brain health.

Understanding the Research

The study, published in the Journal of Alzheimer’s Disease, explored how individuals with Type 2 diabetes process certain proteins associated with Alzheimer’s. These proteins, known as beta-amyloids, are key components of the plaques found in the brains of those with Alzheimer’s disease. The research team, led by Professor Olov Rolandsson from the Department of Public Health and Clinical Medicine at Umeå University, focused on two specific beta-amyloids: Aβ1-40 and Aβ1-42.

To investigate the body’s ability to manage these proteins, researchers conducted an experiment involving ten individuals with Type 2 diabetes and eleven healthy participants. Both groups were subjected to a glucose infusion that induced acute hyperglycaemia, or elevated blood sugar levels, for four hours. Following this, the researchers measured the concentrations of beta-amyloids and an enzyme responsible for breaking down these proteins in the blood of all participants.

The results were telling. While the healthy participants showed a significant decrease in beta-amyloid levels and an increase in the amyloid-degrading enzyme after the glucose infusion, the group with Type 2 diabetes exhibited no such changes. This suggests that individuals with Type 2 diabetes may struggle to eliminate beta-amyloids from their system, potentially leading to the accumulation of these proteins in the brain and, subsequently, an increased risk of Alzheimer’s disease.

Implications for Public Health and Lifestyle Adaptations

The findings of this study highlight the critical importance of managing Type 2 diabetes not only to prevent traditional complications but also to safeguard cognitive health. As Professor Rolandsson points out, while more research is needed to confirm these results, the study underscores the necessity of preventing Type 2 diabetes and controlling blood sugar levels in those who already have the condition.

For those living with Type 2 diabetes, these findings offer a powerful reminder of the importance of lifestyle adaptations that can help manage the disease and protect against cognitive decline. Here are some strategies that can make a significant difference:

1. Maintain a Balanced Diet: Consuming a diet rich in whole grains, vegetables, fruits, and lean plant-based proteins can help regulate blood sugar levels. Avoiding processed foods, sugary drinks, and excessive carbohydrates is key to preventing spikes in blood sugar.
2. Engage in Regular Physical Activity: Exercise is one of the most effective ways to improve insulin sensitivity and lower blood sugar levels. Regular physical activity, such as walking, swimming, or cycling, can also support brain health by promoting better blood flow and reducing inflammation.
3. Monitor Blood Sugar Levels: Regular monitoring of blood glucose levels allows individuals to manage their condition more effectively and prevent episodes of hyperglycaemia, which this study suggests may be particularly harmful in terms of cognitive health.
4. Stay Hydrated: Adequate hydration is crucial for overall health, including brain function. Dehydration can lead to concentration problems and may exacerbate the effects of high blood sugar on the brain.
5. Prioritise Mental Wellbeing: Stress management techniques such as meditation, yoga, and deep breathing can help regulate blood sugar levels and reduce the risk of cognitive decline. Mental wellbeing is closely linked to physical health, and managing stress is particularly important for those with diabetes.
6. Get Regular Check-ups: Regular medical check-ups are essential for managing all forms of diabetes – including Type 2 – and catching any potential complications early. Working closely with healthcare providers ensures that blood sugar levels are kept in check and that the risk of cognitive issues is minimised.

The Role of CMA Members in Supporting Type 2 Diabetes Patients with Alzheimer’s and Cognitive Decline

Members of The Complementary Medical Association (CMA) play a crucial role in helping individuals manage Type 2 diabetes and protect against cognitive decline. By offering guidance on lifestyle changes, nutrition, and stress management, CMA Members can empower their clients to take control of their health and reduce their risk of developing conditions like Alzheimer’s disease.

CMA Members, who are experts in natural and complementary medicine, can also offer personalised advice on supplements, herbs, and complementary medical approaches that support brain health and improve insulin sensitivity. For instance, several herbs and nutrients have been studied for their neuroprotective properties and potential benefits in protecting against cognitive decline, particularly in individuals with Type 2 diabetes. Here’s a detailed look at some of these:

1. Turmeric (Curcumin)

How it’s used: Turmeric, particularly its active compound curcumin, is widely recognised for its anti-inflammatory and antioxidant properties. Curcumin has been shown to cross the blood-brain barrier, which means it can directly affect brain function.

Evidence: Studies suggest that curcumin can help reduce the accumulation of beta-amyloid plaques in the brain, which are associated with Alzheimer’s disease. A study published in the journal Annals of Indian Academy of Neurology¹ highlighted curcumin’s potential to improve cognitive function in patients with Alzheimer’s.

How to incorporate: Turmeric can be added to food, taken as a supplement, or consumed as a tea. Combining turmeric with black pepper enhances curcumin absorption, making it more effective.

2. Ginkgo Biloba

How it’s used: Ginkgo biloba is one of the oldest herbal medicines, commonly used to enhance memory and cognitive function. It is believed to improve blood flow to the brain and act as an antioxidant.

Evidence: A systematic review published in the Journal of Alzheimer’s Disease,^2,3 found that Ginkgo biloba could have a positive effect on cognitive function, particularly in slowing cognitive decline in elderly individuals and those with dementia.

How to incorporate: Ginkgo biloba is typically taken as a supplement in capsule or tablet form. It is also available as a tea.

3. Omega-3 Fatty Acids

How it’s used: Omega-3 fatty acids, particularly DHA (docosahexaenoic acid), are crucial for brain health. They are known for their anti-inflammatory properties and their role in maintaining the structure and function of brain cells.

Evidence: Research published in the Journal of Alzheimer’s Disease⁴ has shown that Omega-3 fatty acids may help reduce the risk of cognitive decline and Alzheimer’s by lowering beta-amyloid production and promoting synaptic plasticity.

How to incorporate: Plant sources of Omega-3s are recommended by The CMA.  There are too many contaminants in fish oils and our oceans are seriously depleted of fish and intensive fishing is seriously impacting ocean ecology. Omega-3 fatty acids are easily found in a variety of plant foods. Sources include walnuts, flaxseed, chia seeds, hemp seeds, edamame, seaweed, and algae. Other green leafy vegetables and beans also contain small amounts. Contrary to some schools of thought, plant source Omega-3s are bioavailable.

4. Bacopa Monnieri (Brahmi)

How it’s used: Bacopa Monnieri, also known as Brahmi, is a traditional herb used in Ayurvedic medicine to enhance cognitive function, memory, and concentration.

Evidence: Studies suggest that Bacopa Monnieri can improve memory and cognitive function by reducing oxidative stress and protecting neural cells. A review in Rejuvenation Research⁵ found that Bacopa could potentially improve memory recall and reduce anxiety, making it a promising supplement for cognitive health.

How to incorporate: Bacopa Monnieri is available as a supplement in capsule or tablet form, and it can also be taken as an extract or tea.

5. Vitamin E

How it’s used: Vitamin E is a powerful antioxidant that protects cells from oxidative stress, which is implicated in cognitive decline and Alzheimer’s disease.

Evidence: A meta-analysis published in Cochrane Database Systematic Reviews⁶ found that high doses of Vitamin E could help slow the progression of Alzheimer’s disease. Vitamin E’s neuroprotective effect is largely attributed to its ability to reduce oxidative damage in the brain.

How to incorporate: Vitamin E can be obtained through diet by consuming nuts, seeds, spinach, and broccoli, or through supplements. However, it’s important to consult a healthcare provider before starting high-dose Vitamin E supplements.

6. Ashwagandha

How it’s used: Ashwagandha is an adaptogenic herb that has been used in traditional Indian medicine for centuries to reduce stress, improve energy levels, and enhance cognitive function.

Evidence: Research published in the journal Nutrients⁷ indicates that Ashwagandha may improve cognitive function and memory by reducing oxidative stress and inflammation, as well as by promoting the growth of new neural pathways.

How to incorporate: Ashwagandha is available as a powder, capsule, or tincture. It can be taken with warm plant-based milks or water, typically in the evening to promote relaxation and improve sleep, which is also vital for cognitive health.

7. Green Tea (EGCG)

How it’s used: Green tea contains a powerful antioxidant known as epigallocatechin gallate (EGCG), which has neuroprotective effects.

Evidence: Studies published in Neurochemical Research⁸ suggest that EGCG can protect brain cells from oxidative stress and reduce the formation of beta-amyloid plaques, which are linked to Alzheimer’s disease.

How to incorporate: Green tea can be consumed daily as a beverage. For higher doses of EGCG, green tea extract supplements are also available.

Integrating these herbs and nutrients into the diet or as supplements can offer additional protection against cognitive decline, especially for those with Type 2 diabetes. However, it’s essential to approach supplementation under the guidance of a qualified healthcare professional, particularly when managing chronic conditions like diabetes. CMA Members, with their expertise in natural health, can provide personalised advice on incorporating these neuroprotective agents into a comprehensive wellness plan, helping to safeguard both physical and cognitive health.

Furthermore, CMA practitioners can provide holistic approaches that address both the physical and emotional aspects of living with diabetes. By focusing on the whole person, rather than just the disease, they can help clients achieve better overall health and wellbeing.

Final thoughts

The link between Type 2 diabetes and an increased risk of cognitive decline, as highlighted by the Umeå University study, serves as a crucial reminder of the importance of comprehensive diabetes management. By making targeted lifestyle adaptations and working closely with healthcare providers, including CMA Members, people with Type 2 diabetes can significantly reduce their risk of cognitive issues and enjoy a healthier, more fulfilling life.

As research continues to uncover the connections between diabetes and brain health, the need for proactive prevention and management strategies becomes ever more apparent. For those at risk or already living with Type 2 diabetes, the time to act is now—both to protect physical health and to ensure cognitive vitality well into the future.

References

1 Mishra S, Palanivelu K. The effect of curcumin (turmeric) on Alzheimer’s disease: An overview. Ann Indian Acad Neurol. 2008 Jan;11(1):13-9. doi: 10.4103/0972-2327.40220. PMID: 19966973; PMCID: PMC2781139. https://pubmed.ncbi.nlm.nih.gov/19966973/

2 Tan MS, Yu JT, Tan CC, Wang HF, Meng XF, Wang C, Jiang T, Zhu XC, Tan L. Efficacy and adverse effects of ginkgo biloba for cognitive impairment and dementia: a systematic review and meta-analysis. J Alzheimers Dis. 2015;43(2):589-603. doi: 10.3233/JAD-140837. PMID: 25114079. https://pubmed.ncbi.nlm.nih.gov/25114079/

3 Weinmann, S., et al. (2010). “Effects of Ginkgo biloba in dementia: Systematic review and meta-analysis.” Evidence-Based Complementary and Alternative Medicine, 2010. doi:10.1093/ecam/nen075. https://pubmed.ncbi.nlm.nih.gov/20236541/

4 de Oliveira Otto MC, Wu JHY, Thacker EL, Lai HTM, Lemaitre RN, Padhye N, Song X, King IB, Lopez O, Siscovick DS, Mozaffarian D. Circulating Omega-3 and Omega-6 Fatty Acids, Cognitive Decline, and Dementia in Older Adults. J Alzheimers Dis. 2023;95(3):965-979. doi: 10.3233/JAD-230083. PMID: 37638432; PMCID: PMC10765383. https://pubmed.ncbi.nlm.nih.gov/37638432/

5 Aguiar S, Borowski T. Neuropharmacological review of the nootropic herb Bacopa monnieri. Rejuvenation Res. 2013 Aug;16(4):313-26. doi: 10.1089/rej.2013.1431. PMID: 23772955; PMCID: PMC3746283. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746283/

6 Farina N, Llewellyn D, Isaac MGEKN, Tabet N. Vitamin E for Alzheimer’s dementia and mild cognitive impairment. Cochrane Database Syst Rev. 2017 Apr 18;4(4):CD002854. doi: 10.1002/14651858.CD002854.pub5. PMID: 28418065; PMCID: PMC6478142. https://pubmed.ncbi.nlm.nih.gov/28418065/

7 Leonard M, Dickerson B, Estes L, Gonzalez DE, Jenkins V, Johnson S, Xing D, Yoo C, Ko J, Purpura M, et al. Acute and Repeated Ashwagandha Supplementation Improves Markers of Cognitive Function and Mood. Nutrients. 2024; 16(12):1813. https://doi.org/10.3390/nu16121813

8 Rezai-Zadeh, K., et al. (2005). “EGCG inhibits beta-amyloid-induced cognitive dysfunction by modulating tau pathology in the Alzheimer transgenic mouse.” Neurochemical Research, 30(6-7), 1033-1039. doi:10.1007/s11064-005-6993-0. https://pubmed.ncbi.nlm.nih.gov/18457818/

See also our article on Cognitive Impairment and the effects of healthy lifestyle modifications: https://www.the-cma.org.uk/effect-of-lifestyle-on-cognitive-impairment/