- Both prediabetes and type 2 diabetes increase the risk of brain health problems.
- Researchers at Karolinska Institutet have confirmed using brain imaging that both diabetes and prediabetes are associated with accelerated brain aging.
- Scientists have found that making healthy lifestyle choices, such as not smoking, may help offset the negative effects of diabetes on the brain.
Researchers estimate that approximately 540 million people worldwide have diabetes, of which approximately 98% have type 2 diabetes.
Past studies have linked prediabetes and type 2 diabetes to an increased risk of certain brain-related health problems. For example, a study published in February 2021 linked prediabetes to
“Diabetes is a well-established risk factor for dementia, but the role of diabetes and its preclinical manifestation, known as prediabetes, in the early stages of dementia is unclear.
Dove is the lead author of a new study recently published in the journal Diabetes Care.
The study reports that while people with type 2 diabetes and prediabetes may be at risk for accelerated brain aging, making healthy lifestyle choices, such as not smoking, may help them improve their brain health.
To conduct the study, Dove and her team looked at MRI brain scans from more than 31,000 people aged 40 to 70 in the UK Biobank. At baseline, about 43% of the study participants had prediabetes and nearly 4% had diabetes.
All participants underwent up to two MRI brain scans during the 11-year follow-up. The researchers calculated each participant’s brain age using the following method:
After analysis, the researchers found that both prediabetes and diabetes were associated with a brain age that was 0.5 and 2.3 years older than a person’s actual age, respectively.
“There are several potential biological pathways through which (prediabetes) may affect brain health,” Dove explained.
“Hyperglycemia is the main pathophysiological feature of diabetes and can promote
Endothelial dysfunction oxidative stress, systemic inflammation, and accumulation of advanced glycation end products. These factors together lead toBlood-brain barrier Permeability – exposing the brain to potentially toxic substances, causing abnormal neural activity –Demyelination axonal loss leading to brain atrophy and disruption of neurotransmitter signaling, and altered Ca2+ signaling leading to excitotoxicity and disruption of gene expression.”
– Abigail Dove Oct 24 ’17 at 14:25
“In addition, the microvascular and macrovascular complications of diabetes may contribute to cerebral atherosclerosis and cerebrovascular disease, which in turn may reduce the incidence of neurodegenerative diseases,” she continued. “Finally, diabetes-specific insulin resistance has been implicated in Alzheimer’s disease-related processes, including
During the study, the researchers also found that the gap between the brain age of diabetic patients and their actual age increased slightly over time.
However, these associations were reduced for participants who participated in high-intensity physical activity and did not smoke or drink alcohol.
“In this analysis, we were curious whether the negative effects of diabetes on brain health could be mitigated to some extent by a healthy lifestyle,” Dove elaborated. “We divided the participants into six groups based on glycemic status (normoglycemia, prediabetes, diabetes) and lifestyle (optimal lifestyle (i.e., no smoking, no alcohol, high physical activity)).”
“The difference between brain age and chronological age was significantly smaller in the diabetes + optimal lifestyle group compared to the diabetes + non-optimal lifestyle group, suggesting that lifestyle can offset the harmful effects of diabetes. Importantly, all of the lifestyle factors we considered – smoking, alcohol consumption, physical activity – are easily modifiable, so these findings provide actionable strategies that people with diabetes can consider adopting to improve their brain health.”
– Abigail Dove Oct 24 ’17 at 14:25
After reviewing the study, board-certified geriatrician Scott Kaiser, MD, director of geriatric cognitive health at the Pacific Neuroscience Institute in Santa Monica, California, told Mongol This is an important, excellent study that reinforces much of what we know about the importance of a healthy lifestyle and effective management of diabetes for brain health and reducing the risk of dementia.
“There’s no doubt that diabetes, in addition to its many potential negative effects, increases the risk and severity of dementia – that’s been well established. So it’s important to think about how to reduce that risk – a brain-healthy lifestyle, including being physically active, avoiding smoking, avoiding excessive alcohol consumption… diet… and a variety of other factors are really important in keeping the brain healthy and reducing dementia risk.”
— Scott Kaiser, MD
“Our population is ageing and with it comes a rising risk of dementia, so
Kaiser noted that the study showed an association, but causality has not been 100% determined.
“I think more prospective studies demonstrating direct causal effects and pathways are important, but more importantly, interventions that can leverage that information (could) have a huge impact,” he continued. “This study provides a really good target for lifestyle interventions to promote brain health, which is really important, again, when you think about this not just at the individual level, but at the population level.”