Dementia – Another Reason to Dread Diabetes
Diabetes is considered as a life cursing disease as it is cureless and heralds a number of complications, of which cardiac diseases, retinopathy and nephropathy are the major ones. It significantly increases the rate of morbidity and mortality. According to World Health Organization, in 2011, there were 347 people worldwide suffering from diabetes, causing more than 80% deaths in middle and low income countries.
It has been established that diabetes also impairs cognitive functions. Of these, the notorious one is dementia. Previously we were all alarmed by Alzheimer disease, which also causes memory loss. But diabetes has added in its list another reason to fear – it has been linked with dementia. But this does not stop at diabetics only. Those people who are not diabetic but suffer from hyperglycemia are also at risk of this impairment, though not as severely or frequently as diabetics.
Dementia is an unfavorable outcome of hyperglycemia and hence, of diabetes too. Higher glucose levels may contribute to an increased risk of dementia through several potential mechanisms, including acute and chronic hyperglycemia and insulin resistance and increased microvascular disease of the central nervous system. This was pointed out in a study published in 2011, which links hyperglycemia with dementia in the elderly people having diabetes. Studies also correlate the possibility of normal high fasting blood sugar as a risk factor for dementia. In this context, it will not come as a surprise that metformin, which is a very potent drug for diabetes, attenuates dementia and Alzheimer’s disease like neuropathology, but it has been implicated in mice only.
Temporary hyperglycemia often occurs in people but it is symptomless. However, persistently high hyperglycemia over a period of years is associated with a wide variety of symptoms and complications, of which dementia is a negative dilemma. Hyperglycemia may be due to diabetes mellitus (the foremost cause), drugs including corticosteroids, octreotide, beta blockers, epinephrine, thiazide diuretics, niacin, protease inhibitors, some antipsychotic agents, etc. and some critical illnesses like stroke and myocardial infarction (these may be due to undiagnosed diabetes), dysfunction of the thyroid, adrenal, pituitary glands and most notably of the pancreas, sepsis, etc.
As mentioned earlier, diabetes is a very common disease globally and its adverse complications multiply its unpleasant course.
As compared to non-diabetics, such people are more prone to develop dementia in later life if their blood sugar level remains persistently elevated. It is necessary to not only address this disease but also those people who have not been diagnosed as diabetic yet but have a strong family history of diabetes or are otherwise at high risk of it, should have their blood glucose levels monitored from time to time in order to avoid asymptomatic hyperglycemia. Diabetes and dementia are both diseases that have no ultimate treatment. But as the old adage goes ‘Prevention is better than cure’, we can minimize its risk by proper precautions and adequate measures.
Join JPMS Medical Blogs Team as Editor or Contributor, email your cover letter and resume to [email protected]
We welcome Guest posts. Submit online via: http://blogs.jpmsonline.com/submit/
Disclaimer: JPMS Medical Blogs are published by the same publisher of Journal of Pakistan Medical Students (JPMS). This article does not reflect the policies of JPMS or its Staff or Editorial nor it intends to provide legal, financial or medical advice. Refer to Disclaimer and Policies section for more details.
Advertisement: Call for Papers for Journal of Pakistan Medical Students (www.jpmsonline.com): Submit Original Article, Review Article, Case Report, Letter to the Editor, News Article, Clinical Images, Perspectives or Elective Report to JPMS. We also publish Conference Proceedings and Conference Abstracts as Supplement. No paper submission or publication charges. Submit your articles online (click here) or send it as an Email to: [email protected] and Causes