Diabetes increases Alzheimer's risk by 65%

Main Category: Diabetes
Also Included In: Alzheimer's / Dementia
Article Date: 18 May 2004 - 0:00 PDT

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If you have diabetes your chances of developing Alzheimer's disease are 65% higher than if you were not diabetic, according to a new study funded by the National Institute of Aging, USA. The number of people with diabetes (type 2) in the USA could triple by the middle of this century.

Neil Buckholtz, Research Director, National Institute of Aging, said "We know how to treat and how to prevent diabetes. The evidence is building that there really is something to this relationship."

In this study 824 nuns, priests and monks over 55 were monitored. They come from all over the USA. These people agreed to have an evaluation every year and have their brains examined after they died.

The study was carried out at the Medical Center, Rush University, Chicago, USA. The study was part of its Religious Orders Study.

Lead author of the study, Zoe Arvanitakis, said that their findings showed that diabetics had a higher risk of developing Alzheimer's disease even after adjustments had been made for age, sex and stroke. The volunteers were monitored for an average of five-and-a-half years.

Even at the beginning of their study, they noticed that the diabetic volunteers performed less well on memory and visual speed tests. They also noticed that the diabetics had faster deteriorating abilities to perceive distinctions between similar items. This indicated that diabetes increases the risk of deterioration of cognitive functions (the way we think, reason and work things out).

An earlier study had indicated that there might have been a link between diabetes and Alzheimer's. The present study confirms this.

Diabetes is associated with many health risks. Here is a list of them:

HEALTH RISKS ASSOCIATED WITH DIABETES

Diabetes mellitus is a potentially life threatening disease with the risk for a number of serious complications. Possible acute complications include, among others, diabetic ketoacidosis or hyperosmolar coma on the one side of the spectrum and hypoglycaemia eventually with coma in overtreated patients on the other side. The major threat for people with diabetes are the late complications involving the small vessels (Microangiopathy) and medium- and large-size vessel disease (Macroangiopathy), which is a progressive form of atherosclerosis.

1. Microangiopathy

Microangiopathy in diabetes mellitus is largely caused by bad blood glucose and blood pressure control. The main complications are

a) Diabetic Retinopathy

In ill-treated patients diabetic rethinopathy may lead to loss of vision.rethinopathy can be easily detected by fundus fotography. We now have excellent methods to prevent or treat diabetic rethinopathy. We routinely screen our patients for diabetec eye disease and we have an excellent cooperation with an ophtalmology unit specialized in diabetec eye disease.

b) Diabetic Nephropathy (kidney disturbances)

Diabetic nephropathy may lead to loss of kidney function. Microalbuminuria (increased excretion of the small protein albumin in the urine) is an early sign of diabetic nephropathy. The appearance or progression of diabetic nephropathy can now be prevented or treated by adequate methods that we render available to all our patients. For patients with specific kidney problems we have an excellent cooperation with a specialized Nephrology Clinic.

c) Diabetic Neuropathy

Diabetic neuropahty may lead to crippling impairment of nerve function with severe pain in the legs and other body sites as well as impairment of autonomic nerve functions. In the western world diabetic neuropathy is by far the primary cause for foot ulcers and amputations.We have a special unit caring for patients with diabetic neuropathy and also a unit specially caring for patients with a diabetic foot syndrome.

2. Macroangiopathy (progressive atherosclerosis)

Diabetic macroangiopathy includes cardiovascular disturbancies with early and progressive atherosclerosis and a high risk for major complications. Macroangiopathy ist often prevalent even in an early stage of type 2 diabetes and also as a late complication of type 1 diabetes. Macroangiopatic complications include, among others,

a) Coronary heart disease (CHD)

Coronary heart disease is a serious complication of diabetes. It may result in angina and eventually myocardial infarction (MI) or death. It should be mentioned that in people with diabetes even severe coronary heart disease and a life threatening-myocardial infarction may occur without a sensation of pain (silent infarction). This makes screening procedures absolutely necessary in people with diabetes mellitus. It is also important to know that coronary heart disease in patients with diabetes mellitus requires specific medical treatment in order to prevent myocardial infarction or a life-threatening recurrent MI. We routinely screen our patients for CHD and we have an excellent cooperation with the Cardiology Clinic at our university, caring for all special cardiac problems in our patients.

b) Left ventricular failure

The risk for impaired cardiac function is increased in patients with diabetes mellitus. This may require special attention and treatment. We routinely screen our patients for cardiac function including exercise electrocardiography, ultrasound of the heart and stress echocardiography. For patients with specific problems we have an excellent cooperation with the Cardiology Clinic at the university.

c) Carotid artery stenosis and stroke

People with diabetes have a significantly increased risk for carotid artery stenosis and for stroke. Patient with diabetes and associated risk factors such as hypertension, dyslipidaemia and cigarette smoking demand special attention and most of them require specific treatment to prevent stroke. We routinely screen all our patients for carotid artery stenosis and for small vessel disease of the brain as well as for cardiac conditions baring the risk for cerebral thrombosis. We also have a close cooperation with the Neurology Clinic at the university caring for all our diabetic patients with specific neurology.

d) Peripheral artery stenosis

People with diabetes mellitus bare an increased risk for peripheral artery stenosis. This is especially the case in cigarette smokers with diabetes. We routinely screen our patients for peripheral arterial disease including walk test and duplex examinations of the vessels. For special problems we have an interdisziplinary cooperation with a specialized radiologist and vascular surgeons.

3. The diabetic foot syndrome

The diabetic foot syndrome is mostly caused by diabetic neuropathy, sometimes with a combination of peripheral artery stenosis. Foot ulcers and also bone deformations of the foot are major problems in patients with diabetes mellitus and they are also the major cause for amputations in such patients. Our specific foot unit has ample experience with all the specific problems of that syndrome. Indead about 50% of amputations can be prevented by adequate therapy which includes a close cooperation with vascular surgeons, neurologists, the Orthopaedic Clinic of our university and an orthopaedic shoemaker.