Yesterday's bit of depressing news for people with diabetes is a Swedish study that is being reported in the news with headlines like "Alzheimers Risk Tied to Diabetes in Middle Age"
The abstract of the actual study is HERE
It is titled, "Impaired insulin secretion increases the risk of Alzheimer disease."
Apparently they gave a group of 2,322 men intravenous glucose tolerance tests in 1970 and then followed them for the rest of their lives tracking which ones developed Alzheimer's disease and dementias.
The researchers conclude, "A low insulin response at baseline was associated with a higher cumulative risk of AD. Impaired glucose tolerance was associated with a higher risk of vascular dementia."
Unfortunately, from the brief description available in the free abstract, it isn't clear what they actually measured. They did intravenous glucose tolerance tests, but the way the report mixes the terms "insulin response" and "insulin resistance" does not make it clear whether they are talking about low insulin secretion or high insulin resistance, and these are two very different metabolic issues.
[NOTE: Dr. John Griffa informed me that the study DID measure insulin levels.]
Beyond that, though, before we conclude that it is only time until our brains are toast, we have the problem, once again, that the study is not able to tell us whether the brain damage was caused by the underlying condition that causes insulin resistance and/or insulin deficiency of if it was the result of long term exposure to the high blood sugars that doctors fail to treat aggressively in people who have either insulin resistance or insulin deficiency.
If it's something in the genes causing the damage, well, a lot of us are screwed. But if, like so many other diabetic complications, the damage is done by exposure to high levels of circulating glucose which gradually clog up the works all over the body, we aren't.
And in a world where doctors tell patients that A1cs of 7.2% are "great control" and refuse to give any treatment to most people with Type 2 diabetes until their A1cs are well over 8%, most people with IR and insulin deficiency under a doctor's care are walking around with very high blood sugars indeed. So we aren't likely to see any studies that look at the incidence of either Alzheimer's or dementia in people who keep their blood sugars in the normal range, no matter what their IR or insulin secretory capacity.
If this latest report worried you, remind yourself of this: No matter how bad your blood sugar might be, it is possible to get it back to normal levels. The tools are simple and well known.
1. Cut way back on carbohydrates. It is carbohydrates that raise blood sugar and the less carb you eat the less of a rise you will see in your blood sugar.
2. Exercise if you can. Exercise reduces insulin resistance and encourages glucose uptake in muscle cells.
3. If diet and exercise don't do the job, investigate which of the available, safe diabetes drugs might work for you.
4. If oral drugs don't work, use insulin and insist that your doctor work with you to find a dose that gives you good control.
Far too many doctors do not know that people with diabetes can get normal blood sugars. Hence their belief that the 7% A1c that represents an average blood sugar near 170 mg/dl is "good control." Even more doctors dismiss the blood sugar levels defined as impaired glucose tolerance as merely, "Nothing to worry about." This study makes it clear that they are more than that. Unless you think being demented is nothing to worry about.
A lot of recent research makes it pretty clear that blood sugars are over 140 mg/dl 2 hours after a meal very slowly damage capillaries, nerves and retinas. Now this new study suggests they are also clogging up the tiny veins in the brain.
But until there is some definitive proof that it is the underlying condition leading to insulin resistance or deficiency rather than exposure to high blood sugars caused by IR and ID, that does the damage, there is hope.
And there is also one more reason to strive for normal blood sugars, not the much-too-high blood sugars that the ADA defines as "tight control."
No comments:
Post a Comment