Studies have shown that diabetes increases the risk of developing dementia by 63 percent. For this reason, keeping your blood glucose level under control is essential in decreasing the risk of developing dementia.
As long as studies on diabetes will continue, interesting results are obtained. One interesting study was conducted on the relationship between diabetes and Alzheimer. Well then, what kind of a relation exists between the two disorders? Based on information communicated by Prof. Dr. Türker Şahiner, head of neurology at Anadolu Medical Center, vascular dementia occurring due to a stenosis of capillaries is ranked second following Alzheimer disease among the many causes of dementia.
As capillary vessels are occluded in patients with vascular dementia, dementia occurs in an insidious manner without obvious warning symptoms. Among reasons leading to the stenosis of vessels, increased blood glucose level and high blood pressure are ranked first among risk factors of vascular stenosis.
But does an increased blood glucose level have any impacts on the occurrence of Alzheimer as well? Stating that the number of authors recognizing the role of diabetes in the occurrence of Alzheimer is gradually increasing, Prof. Şahiner added that “Based on recent scientific data for the above mentioned assumption, increased blood glucose level also seems to increase the risk of Alzheimer’s”.
Although more studies are being done, the mechanism where diabetes has its impact on the occurrence of Alzheimer’s is not known.
Diabetes also affects the progression rate of Alzheimer
A recent study with exciting results on this relationship was published in August 2009 by researchers at Uppsala University, Sweden. In this study, the relationship between long-term glucose metabolism, insulin secretion, Alzheimer disease and vascular stenosis-derived dementia were examined. According to their results, insulin levels of 1125 male subjects aged 71 years without dementia between 1990 and 1995 were measured using an oral glucose challenge test. Later, those subjects were followed for 12 years for their health status. In total, 257 subjects demonstrated dementia and memory disorders. Among those 257 patients, 81 were diagnosed as Alzheimer and 26 patients were as vascular dementia.
While considering differences between patients in terms of blood pressure, body mass index, cholesterol levels, smoking status and education status, results revealed that patients with a “low insulin secretion following glucose challenge” have a low risk of Alzheimer. It was also noted that an increased risk was valid in patients with vascular dementia.
With regards to the information communicated by Prof. Dr. Türker Şahiner, another interesting point on the relationship between diabetes and Alzheimer’s is a faster deterioration of memory functions in patients with diabetes. In another study, it was emphasized that diabetes paves the way for Alzheimer’s and increases its progression rate.
Prof. Dr. Türker Şahiner stated that recent studies will clearly define the relationship between diabetes and Alzheimer’s and added “If we would like to avoid risk factors of Alzheimer’s, which has no current definitive therapy, we should first keep our glucose level under control. We may have the opportunity to benefit from promising treatment options to be introduced in the near future."
Frequency of Diabetes in Turkey and the World
Diabetes is worldwide recognized as a global healthcare issue. Due to its gradual increase in frequency and ability to cause other chronic diseases, the significance of the disease has increased. While studies have indicated that over 150 million people have diabetes worldwide, it is estimated that this figure will exceed 300 million in 2025.
Dr. Mithat Bıyıklı, endocrinologist and diabetes specialist of Anadolu Medical Center, emphasized that the incidence of diabetes in Turkish population is 7.2 percent whereas the incidence of glucose intolerance, or in other words, impaired fasting glucose, which has a significant role in the development of diabetes, is 6.7 percent.
Blood glucose level targets in diabetes
Emphasizing the necessity to keep blood glucose levels within a safe range as defined in the international guidelines, Dr. Mithat Bıyıklı explained those targets as follows:
“The fasting blood glucose levels of the patient should range between 80 and 110 mg/dl both in laboratory blood tests and self measurements of the patient at home using a blood glucose meter. Another issue as important as fasting blood glucose is post-prandial blood glucose (after meal). Also, post-prandial blood glucose level measured two hours following the meal at each of three meals should be between 80 and 140 mg/dl.
Considering the treatment of diabetes, hypoglycemia, or low blood glucose level, is as important as high blood glucose levels. We recognize the lower normal limit of blood glucose as 80 mg/dl. If test results are between 60 and 80 mg/dl, we definitely take measures against hypoglycemia. We re-adjust medication dosages of the patient and review the diet. Hypoglycemia levels below 60 mg/dl are recognized as risky figures and urgent measures should be taken for increasing blood glucose levels.
If a fasting blood glucose level is below 110 mg/dl and post-prandial 2-hour blood glucose levels below 140 mg/dl, "Hemoglobin A1c" levels of the patient are measured. We tell patients it is their “school report grade” in order to emphasize significance of HgA1c, which is recognized as the most recent and important target for controlling blood glucose. The HgA1c test reflects mean blood glucose level of the patient for the last three months and indicates the success of a treatment in terms of blood glucose control, ideally below 6.5 percent.
