FIRST MAGAZINE NOVEMBER 2023 No347 THE PEARL JUBILEE ISSUE

DIABETES
There are several ways Diabetes
control has been linked to
Dementia. Multiple research
projects around the world are
currently studying the neurochemical way
in which raised sugar levels affect the
brain.
Some theories include that high sugar
levels around the body trigger an
inflammatory response, the same way a cut
in the skin does. The body releases
numerous chemicals at the site to reduce
inflammation, but when done
inappropriately, these same chemicals may
do more harm than good. The high sugar
levels around the body cause this process to
occur at multiple sites in the body,
including the brain, and this may cause
direct damage to the cells of the brain. The
damage to brain cells is often irreversible,
and this may lead to Dementia.
The same chemicals of inflammation can
trigger the brain to produce proteins such
as amyloid and tau. These proteins change
the brain cell structure. In larger quantities
these proteins alter the entire structure of
the brain, and with a change in structure
comes a change in function. These leads to
Dementia, most commonly, Alzheimer’s
Dementia.
Prolonged high sugar levels around the
body also cause the body to become insulin
resistant. This means that the hormone
insulin whose function is to decrease the
level of sugar in the blood system becomes
less effective and exposes multiple organs
to higher-than-normal sugar levels over
time. Apart from the inflammatory
response already mentioned, this causes a
change in the cellular pathways of
producing energy for our cells to work
across various organs. This includes the
brain. The brain has been shown in
numerous studies to decrease in function
of memory, thinking, and overall reasoning
when exposed to high sugar levels.
Finally, it must be added that
uncontrolled Diabetes increases an
individual’s risk of strokes. Strokes are
interruptions in the brain’s blood flow and
therefore nutrient administration. Because
of its fragile and complex structure, even
minimal changes in blood flow to the brain
can have catastrophic consequences in
terms of brain cell death. This is the
mechanism that leads to a type of
Dementia called Vascular Dementia.
Moreover, it must be mentioned that
while Diabetes on its own may be
dangerous if uncontrolled, in association
with other conditions its effects may be
compounded. Some of these conditions
include overweight or obesity, high blood
pressure, high blood cholesterol levels, low
physical activity, smoking, and increased
alcohol consumption.
THE GOOD NEWS
Despite all this however there is
good news; studies have shown
that control of Diabetes, and
control of blood sugar levels
improves cognitive function. This has been
shown in both patients who have Diabetes,
and others who do not. Furthermore,
control of all other factors mentioned –
cholesterol levels, blood pressure, quitting
smoking, and controlled alcohol
consumption – all improve Diabetes
control and Dementia individually.
Imagine therefore the compounded effect
it could have on both these conditions!
Healthcare professionals are more and
more aware of the importance of
controlling Diabetes, and research is always
being dedicated to finding new and
improved ways of doing so, especially to fit
into today’s daily full and hurried lifestyle.
Some easier steps that can be taken
include the following:
A daily brisk walk of up to 30 minutes
may be enough to improve an individual’s
weight control and cardiovascular reserve,
even blood pressure and Diabetes control.
Limiting the foods we eat to smaller
portions of a balanced mix of
carbohydrates, proteins and fats allows our
body to better control elevations in sugar
levels and blood pressure control.
Many measures have been constructed to
assist with habits of alcohol consumption
and smoking, ranging from medications to
psychological therapies and medical
devices. Seeking advice from appropriate
sources and medical authorities could help
find a solution that is tailored to any
individual.
Brain exercise keeps the brain active and
healthy and stimulates the production of
new brain pathways. This activity allows
brain function to remain at its optimum
and decreases the risk of decline that comes
with age. Such exercises include puzzles,
crosswords, or sudoku, but even other
functions such as communication and
social interaction have been shown to
protect brain function.
Diabetes and Dementia are serious
conditions individually, and more
so when they occur together. The
effects they may have on an
individual’s physical and mental health are
significant. However, by understanding the
way they are linked and how they affect
the body and mind, it is possible to take
measures to make sure the risks they pose
are minimised. The simple measures
mentioned above assist greatly and if done
regularly may ameliorate future risks
significantly.
It is always highly recommended that
more detailed information about risks, and
how to take measures to reduce them
including the use of medications, should
always be sought from appropriate sources,
including speaking to local healthcare
professionals such as Specialists in Diabetes
and Dementia, doctors, nurses,
nutritionists, psychologists, and others.
Special clinics dedicated to Diabetes may be found in both public and private sectors. The public sector ones may be accessed as detailed:
https://healthservices.gov.mt/en/MDH/Pages/MDH-Diabetes-and-Endocrine-Centre.aspx
The local Dementia helpline 1771 is a helpline that provides advice to Dementia patients and provides information about the multiple
services offered by the local Dementia Care Directorate within the Active Ageing and Community Care: aacc.gov.mt
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