Statins Up the Risk for Type 2 Diabetes – Part 2

I cannot say that statins caused my diabetes because I had diabetes when statins were prescribed. I can say that I did ask to have to dose reduced because of muscle problems I was having. Reducing the dose has helped and the muscle pain has gone away.

The largest problem is that doctors are prescribing statins willy-nilly and most are not doing a benefits-harm analysis. In addition many doctors are not allowing patients to even attempt to lower cholesterol levels by other means or allowing them to eliminate statins when the have shown that they have lowered their cholesterol levels. Many doctors are also trying to increase the statin dose being taken by patients.

For many people, statin side effects negate any benefits. The statin side effects include:

#1 Muscle pain and damage. This is the most common side effect. You may feel this pain as a soreness, tiredness, or weakness in your muscles. The pain can be a mild discomfort, or it can be severe enough to make your daily activities difficult. For example, you might find climbing stairs or walking to be uncomfortable or tiring.

Very rarely, statins can cause life-threatening muscle damage called rhabdomyolysis. Rhabdomyolysis can cause severe muscle pain, liver damage, kidney failure, and death. Rhabdomyolysis can occur when you take statins in combination with certain drugs or if you take a high dose of statins.

#2 Liver damage. Occasionally, statin use can cause your liver to increase its production of enzymes that help you digest food, drinks, and medications. If the increase is only mild, you can continue to take the drug. Rarely, if the increase is severe, you may need to stop taking the drug. Your doctor might suggest a different statin. Certain other cholesterol-lowering drugs, such as gemfibrozil (Lopid) and niacin (Niacor, Niaspan), slightly increase the risk of liver problems in people who take statins.

Although liver problems are rare, your doctor will likely order a liver enzyme test before or shortly after you begin to take a statin. You shouldn't need any additional liver enzyme tests unless you begin to have signs or symptoms of trouble with your liver. Contact your doctor immediately if you have unusual fatigue or weakness, loss of appetite, pain in your upper abdomen, dark-colored urine, or yellowing of your skin or eyes.

#3 Digestive problems. Some people taking a statin may develop nausea, gas, diarrhea, or constipation after taking a statin. These side effects are rare. Most people who have these side effects already have other problems with their digestive system. Taking your statin medication in the evening with a meal can reduce digestive side effects.

#4 Rash or flushing. You could develop a rash or flushing after you start taking a statin. If you take a statin and niacin, either in a combination pill such as Simcor or as two separate medications, you're more likely to have this side effect. Taking aspirin before taking your statin medication may help, but talk to your doctor first.

#5 Increased blood sugar or type 2 diabetes. It is possible your blood glucose level may increase when you take a statin, which may lead to developing type 2 diabetes. The risk level is being disputed, but important enough that the Food and Drug Administration (FDA) has issued a warning on statin labels regarding blood glucose levels and diabetes. Talk to your doctor if you have concerns.

#6 Neurological side effects. The FDA warns on statin labels that some people have developed memory loss or confusion while taking statins. These side effects reverse once you stop taking the medication. Talk to your doctor if you experience memory loss or confusion. There has also been evidence that statins may help with brain function, in patients with dementia or Alzheimer's, for example. This is still being studied. Don't stop taking your statin medication before talking to your doctor.

Who's at risk of developing statin side effects? Not everyone who takes a statin will have side effects, but some people may be at a greater risk than are others. Risk factors include:

• Taking multiple medications to lower your cholesterol
• Being female
• Having a smaller body frame
• Being age 65 or older
• Having kidney or liver disease
• Having type 1 or 2 diabetes
• Drinking too much alcohol (More than two drinks a day for men age 65 and younger and more than one drink a day for women of all ages and men older than 65)

What causes statin side effects? It's unclear what causes statin side effects, especially muscle pain. Statins work by slowing your body's production of cholesterol. Your body produces all the cholesterol it needs by digesting food and producing new cells on its own. When this natural production is slowed, your body begins to draw the cholesterol it needs from the food you eat, lowering your total cholesterol.

Statins may affect not only your liver's production of cholesterol but also several enzymes in muscle cells that are responsible for muscle growth. The effects of statins on these cells may be the cause of muscle aches.

Statins Up the Risk for Type 2 Diabetes – Part 1

Yes, statins increase the risk for type 2 diabetes! Most doctors have now accepted this as a risk for prescribing statins and many don't care. A recent study appearing on March 4 in Diabetologia has many doctors up in arms and criticism about the study has been heavy. This article in Medscape is typical.

Even I don't like the study because it only included men and not a combination of men and women. Statin therapy appears to increase the risk for type 2 diabetes by 46%, even after adjustment for confounding factors, a large new population-based study concludes.

This suggests a higher risk for diabetes with statins in the general population than has previously been reported, which has been in the region of a 10% to 22% increased risk.

In this new study, the authors investigated the effects of statin treatment on blood glucose control and the risk for type 2 diabetes in 8749 nondiabetic men age 45 to 73 years in a 6-year follow-up of the population-based Metabolic Syndrome in Men (METSIM) trial, based in Kuopio, Finland.

The majority of people in this new study were taking atorvastatin and simvastatin, and the risk for diabetes was dose-dependent for these two agents, the researchers found.

However, senior author Markku Laakso, MD, from the University of Eastern Finland and Kuopio University Hospital, told Medscape Medical News: "Even if statin treatment is increasing the risk of getting diabetes, statins are very effective in reducing cardiovascular risk.” "Therefore I wouldn't make a conclusion from my study that people should stop statin treatment, especially those patients who have a history of myocardial infarction.”

"But what I would say is that people who are at the higher risk, if they are obese, if they have diabetes in the family, etc, should try to lower their statin dose, if possible, because high-dose statin treatment increases the risk vs. lower-dose statin treatment," he continued.

One of the main criticisms came from Alvin C Powers, MD, from Vanderbilt University School of Medicine, Nashville, Tennessee. Asked to comment, Alvin C Powers, MD, explained that there were limitations to the conclusions that could be drawn from this study.

Speaking as part of the Endocrine Society, he said, "The first thing is that this study did not examine the benefits of statin therapy, it examined only the risk of diabetes."

With every treatment, there are risks and benefits, and the benefits of statins have been clearly proven in certain situations. In those instances, "the benefit would outweigh the increased risk of diabetes for many people," Dr. Powers told Medscape Medical News.

Dr Powers observed that this new study doesn't provide any information about whether people who have diabetes who are on a statin should continue with the statin, "but there are clear benefits for statin therapy in people who have diabetes.”

"People who have diabetes who are on a statin should continue with the statin.…This increased risk of diabetes, to me, is not relevant to their reason for taking the statin," he commented.

This is very typical of doctors that favor statins. People receiving statins would I am sure feel otherwise. Anyone that has read Dr. Malcolm Kendrick's book, The Great Cholesterol Con would feel this way.

I would urge everyone to read the latest from the FDA (last updated January 31, 2014) and what they are saying about statins.

Diabetes and Sleep Apnea

I have written more than the one below on sleep apnea, but this is mainly concerning sleep apnea and management of blood glucose.

http://bobsdiabetes.blogspot.com/2014/04/sleep-apnea-makes-diabetes-harder-to.html

The sad part is many people with sleep apnea do not realize that they are at risk for diabetes and a slightly a smaller percentage of those with diabetes are at risk for sleep apnea. Even then, people will not listen when they have one condition and you warn them about the risk for the other.

Sleep apnea and understanding that it affects blood glucose management negatively is important. I am fortunate that I have no problems using my sleep apnea equipment, as I obtain the sleep I need and sleep apnea is not a factor in the management of my blood glucose levels. I have a few acquaintances and a few more friends that ignore their sleep apnea and laugh at me when I bring the following into the discussion.

Some of the reasons people refuse to use their sleep apnea equipment include:

1. Vanity – they don't feel sexy or manly wearing the mask
2. Some feel wearing the mask is claustrophobic
3. Some do not like the lines that the mask straps cause in their skin because they have the straps too tight
4. Many complain about the noise the machine makes
5. Many have a problem with the air leaks around the mask because they aren't properly fitted or having a mask that fits properly
6. Many people do not understand that not getting the sleep they need will contribute to the development of diabetes or make diabetes more difficult to manage.

Severe obstructive sleep apnea (OSA) may increase a person's risk of developing diabetes by 30% or greater. This is according to an article published online June 6, 2014 in the American Journal of Respiratory and Critical Care Medicine.

Of the 8678, patients who underwent the sleep study, 1017 (11.7%) developed diabetes during a median of 67 months of follow-up, which translates to a cumulative incidence of 9.1% at 5 years. Incidence came to 7.5% for patients with mild OSA, 9.9% for moderate OSA, and 14.9% for severe OSA. Limitations of the study include missing data on some potential confounders, such as race and family history of diabetes and the inability to categorize diabetes as type 1 or type 2.

Another author wrote, a man over age 65 with type 2 diabetes has a 67 percent chance of having sleep apnea; for older women, the chance is almost 50 percent. Besides making it difficult to get a good night’s sleep, sleep apnea increases stress on the body, causing blood sugar levels to rise. So it is especially important for people with type 2 diabetes to recognize sleep apnea and have it treated.

People with type 2 diabetes are often obese and insulin resistant, and have large amounts of visceral fat, fat deep inside the body that is covering and surrounding their organs. What causes sleep apnea isn’t entirely known, but there appears to be a connection between insulin resistance, obesity, especially with visceral fat and a big waistline, and sleep apnea. This makes obese people with visceral fat and type 2 diabetes more likely also to have sleep apnea.

The most common symptom of obstructive sleep apnea is loud, persistent snoring, which may include pauses followed by gasping or choking. (Keep in mind that not all snorers have sleep apnea.) Other symptoms include:

• Chronic fatigue (for example, you may fall asleep while driving or during inactive times throughout the day)
• Problems concentrating (inability to complete simple tasks)
• Mood swings (happy one minute and unhappy the next)
• Difficulty controlling blood pressure and blood sugar levels

Sleep and Its Effect on Diabetes

The last blog on Alzheimer's disease is the last on diabetes complications and now I will present some of the related issues.

I know that sleep is important as I found out the hard way and was diagnosed with obstructive sleep apnea over two years before I was diagnosed with type 2 diabetes. I have been following several sleep apnea sites and reading every newsworthy article about sleep since. I would encourage, no, urge everyone to read this article about sleep. Granted, it is about what “experts” feel is the necessary sleep needs for infants through the elderly, but I feel that it is probably closer to reality thinking than just what many “experts” arrive at for other problems.

Please consider clicking on the sleep recommendations chart and then down the page, click on the line to download a printable chart. I have used the chart already in my talks with other people that are asking questions about sleep and have found it very useful.

David Mendosa has two articles about sleep. One on the amount of sleep needed to help avoid diabetes and another on the important role sleep plays in diabetes. I will urge people to read these two articles. Then David follows the two articles with a third about a sleep shortcut for helping people with diabetes.

I have to say this now, as I have done the same thing and to this day have never had anyone thank me for a blog I have written about what to do to help prevent diabetes. It is sort of like preaching to the choir, as most people are not looking for something until after they have diabetes. Yes, I feel these could be important for the right reader, but I feel like most people are not looking for this unless they have diabetes in their immediate family.

Then WebMD has an article about shorting the amount of sleep you get that fits my thoughts exactly. While skimping on sleep may seem like a good idea in the short run, it can have serious long-term consequences. Scientists warn that too little shut-eye may raise type 2 diabetes risks. And if you already have diabetes, sleep deprivation may undermine your blood glucose management. Most of the time, it does make my diabetes management more difficult.

I know the last sentence is true as I have been guilty of doing this and I still get into trouble with this. The article offers these six tips for better sleep.

#1. Keep Regular Bedtime and Waking Hours. This is easier said than done in today's 24-7 society. But experts say you may have less trouble falling asleep if you stick to a regular bedtime and wake time, even on weekends. Be careful about napping too much or too late in the day, which can make it harder to fall asleep at night. Rather than napping, take a walk to refresh yourself.

#2. Create the Right Sleep Environment. Keep your bedroom cool, quiet, and comfortable. Maintain the temperature between 54 F. to 75 F. Cut noise with earplugs or "white noise" machines. Also, keep the room dark. You can block light with heavy shades or curtains, or use an eye mask.

A comfortable mattress and pillow make sleep more restful. If your mattress is getting old, consider buying a new one that offers better support. Keep pets out of your bed. They may wake you if you have allergies or if their movement disturbs you.

#3. Reserve the Bedroom for Sleep and Sex. Think "bedroom," not "home office." Use your bedroom only for sleep or sex, not for paying bills or tackling a pile of paperwork. Consider banning computers and televisions from the bedroom. That way, you'll cut the temptation to stay up Internet-surfing or watching old sitcoms.

Ultimately, you're trying to create a mental association between the bedroom and sleep. If you lie in bed awake for more than 20 minutes, get up and do a relaxing activity, such as reading, until you feel sleepy. Don't lie there staring at your clock. This makes you anxious, and sleep more elusive.

#4. Don't Wind Up. Wind Down. Going to bed soon? This is not the time to break out the kick-boxing exercise video. Sleep experts suggest that you finish exercising at least three hours before turning in. Exercise raises body temperature and heightens alertness -- two obstacles to falling asleep, according to the National Sleep Foundation.

At the same time, exercising earlier in the day may help to improve your sleep. Instead of winding yourself up before bedtime, try winding down. Establish a relaxing bedtime routine, which might include reading or taking a warm bath. Not only will the heat relax you, but afterward, your body temperature will drop in a way that partially mimics what happens when you fall asleep. That makes it easier to drift off.

#5. Watch What You Consume. A light snack or glass of milk before bedtime is fine. But avoid large meals within two hours of bedtime because they can cause indigestion. Too many fluids before bedtime can interrupt your sleep with the need to urinate.

Nicotine and caffeine are stimulants that can disrupt sleep. Avoid caffeine, an ingredient in coffee, tea, chocolate, and colas, for 6-8 hours before bedtime. Smoking before bedtime can make it harder for you to fall asleep. While many people consider alcohol a sedative, it actually disrupts sleep.

#6. Seek Professional Help If You Need It. How much sleep you get is important, but so is the quality. While everyone has trouble sleeping on occasion, you may need to consult your doctor or a sleep specialist about a possible sleep disorder if you have:

• Regular difficulty with sleeping.
• Tiredness during the day even if you've slept at least 7 hours.
• Trouble performing daily activities.

A common and potentially serious disorder called sleep apnea can increase risk of diabetes, if untreated. With sleep apnea, your breathing stops repeatedly or becomes very shallow while you're asleep. Levels of oxygen in your blood may drop. Common symptoms include loud snoring, gasping, or choking. Because the disorder disrupts your sleep, you may feel very sleepy during the day. If you have such symptoms, ask your doctor about testing and treatment.

Alzheimer's Disease – Part 3

If you have a loved one or a parent that you are having difficulty with, forget about everything, and ask your parent if they wish to name you in their medical power of attorney. If they wish to name another sibling or a friend, don't get upset, but ask questions. Maybe the friend lives closer or communicates with your parent every day. Just maybe they trust a sibling more than you and the sibling lives closer. In this case, contact the sibling and inform them of the situation if they are not aware. If they have the medical power of attorney, then step back and let them act.

Yes, you may have good reason to be concerned about a parent, but unless the parent feels they have control, you may not get anywhere. Having a medical power of attorney is an important document and should be obtained while the parent can understand what the medical power of attorney means. Waiting until something happens, and your parent is unable to act on legal matters, may leave the door open to other siblings that may not have your parent's interest and wellbeing in mind, but their own interests.

This is my own opinion and I do not like it when other writers omit this from the discussion or leave it as the last item for discussion. This writer omits this entirely and focuses on other issues. Concern for older parents or aging relatives is a valid concern for a geriatrician as is their safety.

For better health and wellbeing in older adults or parents, it is not enough identifying the underlying health and life problems, although it is a key place to begin. It is understood that a difficult parent or older relative can cause immeasurable frustration and stress.

Dr. Leslie Kernisan lays out four actions that families can take when older parents or relatives are actively resisting help. To this I would add – are the proper legal documents in place and understood by everyone concerned. Here is her list:

#1. Consider the possibility of cognitive impairment. Do not assume that this is the cause, as the parent or older relative may be making health and safety decisions that you don't agree with or feel is wrong.

#2. Make sure you’ve heard and validated your parents’ emotions. This surprised me, but I realized that it is true. Logical arguments can often fail to convince people that we have emotional relationships with, such as parents or older relatives. All people care about having their emotions validated. People also want to feel connection, love, and self-worth.
Whether or not your parent or older relative might be cognitively impaired, it is crucial to remember this. If there is potential Alzheimer’s, it can be even more important to help a parent feel heard and validated because this will reduce stress and help the brain function better. If you can afford it, consider investing in a few sessions with a relationship therapist or another person trained to facilitate family conversations. It can be especially productive to work with someone experienced in helping families address aging issues, like a geriatric care manager

#3. Review your parents’ goals and what trade-offs they might be willing to make. Doctors want to prevent falls, injuries, illnesses, and new medical problems.

People with older parents or relatives generally want what their parents want – to live as long as possible. But, there can be real problems with this as they age. The older adults in our lives want autonomy and independence and this is when the conflicts happen and can cause real dilemmas.

There is usually no easy answer to this conflict. Once an older person becomes more vulnerable in body or mind, you cannot have perfect safety as well as perfect independence. When the trade-offs are identified and goals discussed, it’s usually possible to help everyone feel better.

Common goals of older adults include:

• Living in their own home for as long as possible
• Dictating the terms of their daily life
• Living their usual life for as long as possible
• Minimizing pain, illness and suffering
• Spending quality time with family and loved ones
• A good quality of life, which generally means more enjoyable activities and fewer stressful or burdensome activities.
  
  Safety is important, but don’t fall into the trap of assuming it should always be your family’s No. 1 priority. Because when faced with a trade-off between safety and autonomy, most older adults choose autonomy. This is especially true of people with dementia. An approach called “positive risk-taking” is now being advocated as a way to make communities more dementia-friendly.
  
  

#4. Distinguish what you need from what your parents or older relatives need. This is probably the most difficult part for the younger generation because they refuse to recognize what fear is driving them.

Some common underlying issues include:

• A need to minimize guilt
• A fear of conflict with other siblings
• A fear that a parent is going to decline further and require more help
• A desire to know that a parent is happy and comfortable
• A desire for control and for knowing what will happen next
• A fear that what is happening to our parents might eventually happen to us.
  
  People being people, we all have a tendency to try to address our needs by wanting other people to do something differently, or by trying to keep things from changing. But as the relationship experts have been telling us for decades, the best approach is to accept that things change and to focus on what we can do differently. We shouldn't try to meet our own needs by controlling what others do.
  
  Even when you become informed, are thoughtful in your approach, and obtain the right kind of assistance, helping older parents through this stage of life will be a challenge. Of course, you will worry about them. And they will probably never be entirely free of reluctance to make changes and accept help.
  
  Some families get stuck in a rut of conflict and frustration, whereas others find ways to move forward more constructively. It might feel like an extra effort to do these things. But by investing in your ability to better navigate these difficult situations with your parents, your family will get closer to what we all want: less stress for ourselves and better quality of life for our parents.

Alzheimer's Disease – Part 2

You can support your loved one with Alzheimer's by learning more about how the condition progresses. There are seven stages in the progression of Alzheimer's and they don't always happen neatly or fit neatly into the seven stages. The symptoms might vary, but they can be a guide and help you plan for your loved one's care. The seven stages include:

Stage 1: Normal Outward Behavior. When your loved one is in this early phase, he/she won't have any symptoms that you can spot. Only a PET scan, an imaging test that shows how the brain is working, can reveal whether he/she has Alzheimer's. As the person moves into the next 6 stages, your loved one with Alzheimer's will see more and more changes in his/her thinking and reasoning.

Stage 2: Very Mild Changes. You still might not notice anything amiss in your loved one's behavior, but he may be picking up on small differences, things that even a doctor doesn't catch. This could include forgetting a word or misplacing objects.

At this stage, subtle symptoms of Alzheimer's don't interfere with the ability to work or live independently. Keep in mind that these symptoms might not be Alzheimer's at all, but simply normal changes from aging.

Stage 3: Mild Decline. It's at this point that you start to notice changes in your loved one's thinking and reasoning, such as:

• Forgets something he just read
• Asks the same question over and over
• Has more and more trouble making plans or organizing
• Can't remember names when meeting new people

You can help by being your loved one's "memory" for him, making sure he pays bills and gets to appointments on time. You can also suggest he/she ease stress by retiring from work and putting legal and financial affairs in order.

Stage 4: Moderate Decline. During this period, the problems in thinking and reasoning that you noticed in stage 3 get more obvious, and new issues appear. Your loved one might:

• Forget details about himself/herself
• Have trouble putting the right date and amount on a check
• Forget what month or season it is
• Have trouble cooking meals or even ordering from a menu

You can help with everyday chores and your loved one's safety. Make sure he/she isn't driving anymore, and that someone isn't trying to take advantage of your loved one financially.

Stage 5: Moderately Severe Decline. Your loved one might start to lose track of where he is and what time it is. He/she might have trouble remembering his/her address, phone number, or where he/she went to school. Your loved one could get confused about what kind of clothes to wear for the day or season.

You can help by laying out the clothing in the morning. It can help him/her dress by himself/herself and keep a sense of independence. If your loved one repeats the same question, answer with an even, reassuring voice. Your loved one might be asking the question less to get an answer and more just to know you're there.

Even if your loved one can't remember facts and details, he/she might still be able to tell a story. Invite your loved one to use his/her imagination at those times.

Stage 6: Severe Decline. As Alzheimer's progresses, your loved one might recognize faces but forget names. He/she might also mistake a person for someone else, for instance, thinking the spouse is his/her parent. Delusions might a set in, such as thinking he needs to go to work even though he no longer has a job. You might need to help him/her go to the bathroom. It might be hard to talk, but you can still connect with him/her through the senses. Many people with Alzheimer's love hearing music, being read to, or looking over old photos.

Stage 7: Very Severe Decline. Many basic abilities in a person with Alzheimer's, such as eating, walking, and sitting up, fade during this period. You can stay involved by feeding your loved one with soft, easy-to-swallow food, helping him/her use a spoon, and making sure he/she drinks. This is important, as many people at this stage can no longer tell when they are thirsty.

Please remember that as your loved one evolves into the later stages, some words may be hurtful. When this happens, do not get upset at your loved one, as they do not realize what they are saying.

Alzheimer's Disease – Part 1

Alzheimer's disease and diabetes do have a link. The Mayo Clinic recognizes this, as do a few other organizations. A few organizations reject the link and more state that the link is in question and acknowledge that the evidence is conflicted. New research suggests that those with insulin resistance or diabetes are at significantly higher risk of developing one of today's most devastating and incurable neurological disorders: Alzheimer's disease.

The connection between diabetes and Alzheimer's is yet another compelling reason for those who value their health to address issues of impaired insulin sensitivity before it is too late. Although diabetes is an epidemic, it is also preventable and reversible through strategies that incorporate dietary changes, lifestyle modifications, and nutritional supplementation.

Alzheimer's cost the US $130 billion in 2011 alone. One of the biggest risk factors is having type 2 diabetes. This kind of diabetes occurs when liver, muscle, and fat cells stop responding efficiently to insulin, the hormone that tells them to absorb glucose from the blood. The illness is usually triggered by eating too many sugary and high-fat foods that cause insulin to spike, desensitising cells to its presence. As well as causing obesity, insulin resistance can also lead to cognitive problems such as memory loss and confusion.

While medical researchers have yet to pinpoint a single cause of Alzheimer's disease, they have uncovered some of the basic biochemical processes that underlie the hallmark mental changes seen in Alzheimer's.

First, Alzheimer's sufferers exhibit a marked decline in levels of acetylcholine, a neurotransmitter (that is, a chemical messenger of the nervous system) that is vitally important to memory formation and retention in certain regions of the brain. Second, Alzheimer's patients demonstrate an accumulation of harmful beta amyloid deposits, or senile plaques, in the brain. Third, brain autopsies of Alzheimer's patients show signs of significant oxidative damage induced by free radicals. Finally, new research indicates that advanced glycation end products may also initiate this dreaded condition.

Feeding animals (in this case rats) a diet designed to give them type 2 diabetes leaves their brains riddled with insoluble plaques of a protein called beta-amyloid, one of the calling cards of Alzheimer's. We also know that insulin plays a key role in memory. Taken together, the findings suggest that Alzheimer's might be caused by a type of brain diabetes. If that is the case, the memory problems that often accompany type 2 diabetes may in fact be early-stage Alzheimer's rather than mere cognitive decline.

While declining levels of acetylcholine and formation of beta amyloid plaques in the brain are characteristic of Alzheimer's, oxidative damage and the accumulation of advanced glycation end products occur in both Alzheimer's disease and diabetes. These biochemical similarities may be a telling link between the two seemingly different diseases.

Scientists from Kaiser Permanente in Oakland, CA, reported that diabetic individuals with very poor blood glucose control experienced a dramatically increased risk of dementia and Alzheimer's. Their eight-year study, which tracked 22,852 patients, aged 50 or above with type II diabetes, sought to determine whether elevated glycosylated hemoglobin, a marker of long-term blood glucose control, correlated with an increased risk of dementia. They found that patients with very poor blood glucose control were more likely to develop dementia.

Researchers from the Mount Sinai School of Medicine in New York City discussed the link between diabetes-related toxins and impaired memory function. Advanced glycation end products (AGEs) are increased in people with diabetes, as well as in those with cardiovascular and kidney disease. They are also found in the brains of people with Alzheimer's, and laboratory findings suggest that AGEs may contribute to the formation of Alzheimer's plaques and tangles. The researchers evaluated nearly 200 cognitively healthy people aged 70 or older using tests of memory and thinking ability, and measured AGE levels in their blood. They found that those with the highest AGE levels fared significantly worse on six different tests than those with low AGE levels. This relationship could not be explained by factors such as gender, educational level, heart disease, or related conditions such as high blood pressure. The researchers concluded that dietary and lifestyle interventions to decrease advanced glycation end products in the blood deserve further study for preventing or delaying Alzheimer's disease.

Most of recent research points to a link between diabetes and Alzheimer's Disease. How firm this link is still is in doubt, but more evidence is now in the affirmative.