Diabetes and Alzheimer’s

Alzheimer’s Disease is a form of dementia which affects approximately 1 in 15 people over the age of 65. It is caused by nerve damage in the brain with early signs characterized by confusion, speech difficulties and forgetfulness. Alzheimer’s has been found to be closely linked with type 2 diabetes.

At first glance, diabetes and Alzheimer’s appear to be two distinct diseases. However, a growing body of evidence indicates that diabetes and Alzheimer’s disease (AD) are linked because both conditions involve impaired glucose homeostasis and changes in the way your brain functions.

Link between Diabetes & Alzheimer’s 

Diabetes can cause damage to your blood vessels, among several complications. Since the blood vessels are damaged, the blood vessels in the brain are also affected. This can cause a wide range of brain diseases and disorders. Alzheimer’s is one such condition.

Diabetes is considered a risk factor for vascular dementia. This type of dementia is caused by brain damage from impaired blood flow to your brain.

The cause of Alzheimer’s in itself is not well enough understood at present, and the link between Alzheimer’s and diabetes therefore, is also not clear. However, the two conditions seem to be linked and people who are over 60 with type 2 diabetes are thought to be twice as likely to develop Alzheimer’s as those without diabetes.

Similarities between Diabetes and Alzheimer’s

There are a number of similarities which type 2 diabetes and Alzheimer’s share. Some of them are-

  • Symptoms appear gradually
  • No cure at present
  • Likelihood of conditions increase with age
  • Genetic factors add to risk

Symptoms of Alzheimer’s

Some of the early symptoms of Alzheimer’s you may observe include-

  • Confusion
  • Difficulty in speaking and reading 
  • Forgetfulness
  • Irritability

Alzheimer’s is a progressive illness, hence as it develops the symptoms may include delusion, repetitive behaviour, sharp increase in the frequency of mood swings, loss of memory and incontinence. In the advanced stages, people may not be capable of completing simple tasks such as eating a meal by themselves.

Prevention of diabetes and potential complications

  • Follow your doctor’s recommendations about the most appropriate plan for monitoring your blood glucose, cholesterol level, and blood pressure.
  • Eat healthy foods, including fruits, vegetables, whole grains, lean meats, and low-fat milk and cheese.
  • If you’re overweight, eat a healthy diet and exercise to lose weight. Obesity can lead to diabetes and other health problems.
  • Don’t smoke.
  • Aim to exercise for at least 30 minutes every day.
  • Examine your feet daily for sores.
  • Take any prescribed medications on schedule.

Depression

The occurrence of depression is higher by 2 or 3 times in people with diabetes. Depression is a common and very serious medical disease that causes several symptoms that alter the functioning of an individual. According to a recent study, the presence of depression and anxiety in diabetic patients worsens the progression of diabetes and decreases their response to medical treatment and quality of life. On the other hand, depression may increase the risk of developing diabetes by 60%.

If a person is suffering from diabetes, the exhaustion that comes with managing the disease, can lead to depression. Once the symptoms of depression develop, it can come very hard to manage diabetes leading to physical complications and decreased life expectancy.

Both biological and behavioral factors may play a role in the relationship between depression and diabetes complications. Depression and chronic psychological stress can stimulate the sympathetic nervous system, increase inflammatory responses, and contribute to poor diabetes control. Poor glycemic control increases the risk of diabetes complications. Diabetes itself impairs glycemic control through negative effects on self-care behaviors (adherence to diet, exercise, checking blood glucose, and taking medications as prescribed).

Managing Depression & Diabetes

If you are feeling symptoms of depression, don’t self-medicate and/or keep them to yourself. First, talk them over with your doctor. There may be a physical cause for your depression.

Poor control of diabetes can cause symptoms that look like depression. During the day, high or low blood sugar may make you feel tired or anxious. Low blood sugar levels can also lead to hunger and eating too much. If you have low blood sugar at night, it could disturb your sleep. If you have high blood sugar at night, you may get up often to urinate and then feel tired during the day.

Erectile Dysfunction

Do not take or stop taking medication without telling your doctor. Your doctor will be able to help you discover if a physical problem is at the root of your depression. Regular exercise combined with a healthy diet and a good night’s rest can often boost your energy levels. In addition, mindfulness and other meditation-based techniques are ideal for combating stress and depression and improving mental health.

Erectile Dysfunction, commonly known as ED, is one of the most common sex-related problems that men report to their doctor. It is defined as the trouble experienced getting or keeping an erection that is required to engage in intercourse.

How will you know if you have Erectile Dysfunction?

Among persistent symptoms, the most common ED symptoms include difficulty in getting aroused or obtaining an erection, trouble keeping an erection and a sharp reduction in sexual drive or desire.

How does Diabetes cause Erectile Dysfunction?

In order to have an erection, men need to possess healthy functioning blood vessels, hormones, nerves and an active sexual drive. Erectile Dysfunction occurs when your body experiences diabetes complications which affect those nerves, muscles and blood vessels. You have a chemical called nitric oxide in your body which signals your brain to allow blood flow to your penis. Under any circumstance, if the level of nitric oxide reduces and your blood vessels that control erection become narrow and reduce their ability to function at an optimum level, Erectile Dysfunction takes place.

Diabetes and Hypertension

Nearly 2 in 3 people with diabetes reportedly suffer from high blood pressure or hypertension and take medication to lower their blood pressure. Your heart has to put in extra effort to function when your blood pressure is high leading to an increase in the risk of heart disease, stroke and other physical ailments. High blood pressure won’t go away without treatment. This could include lifestyle changes and medication, if recommended by your doctor.

What is Hypertension or High Blood Pressure?

Blood pressure is the force of blood flow inside your blood vessels. Your doctor records your blood pressure as two numbers, such as 120/80, which you may hear them say as “120 over 80.” Both numbers are important. If your blood pressure reads below 120/80 you have healthy blood pressure, between 120/80 and 140/90 is early high blood pressure and a high blood pressure reads 140/90 or higher.

Cause of Hypertension in Diabetes

Diabetes mellitus and hypertension are frequently present together. A person with diabetes either does not have enough insulin or insulin is not produced at all in the body. As a result of this glucose cannot enter the cells to provide energy and hence gets collected in the blood. As blood with high levels of glucose travels through the body, it can cause damage to the blood vessels and kidneys. These organs play an important role in maintaining healthy blood pressure. If the damage increases, the risk of further complications also increases.

Risk factors for Type 2 Diabetes & Hypertension

Making healthy lifestyle choices from an early age can help prevent both type 2 diabetes and hypertension. People with diabetes can help decrease the risk of high blood pressure and cardiovascular disease by controlling their blood sugar levels.

Diabetic Chronic Fatigue

Chronic Fatigue is one of the most common symptoms of diabetes that is a result of high blood sugar levels. Research shows that more than 55% percent of people with type 2 diabetes report chronic fatigue as a symptom. It is especially disabling, as it interferes with a person’s ability to live a normal and productive life.

Why does fatigue occur in diabetic patients?

There are several reasons as to why diabetes causes fatigue, some of them being:

  • Changes in blood sugar levels
  • Mental and emotional issues resulting from diabetes
  • Being overweight or obese

Diabetic Heart Disease

The most common cause of death in adults with diabetes is related to heart disease. 68% of adults with diabetes above the age of 65 die from some form of heart disease and 16% die from stroke. While these statistics may seem grim, there are ways to protect yourself from developing heart disease.

Symptoms of Diabetic Heart Disease

  • Pain in the chest
  • Short of breath
  • Irregular heartbeat
  • Swelling of ankles

Diabetic Nephropathy

Diabetic Nephropathy or Diabetic Kidney Disease is kidney complication that affects the ability of your kidneys to function efficiently and remove waste products from your body. Statistically, approximately 40% of people who have type 1 and type 2 diabetes develop nephropathy. But it is possible to prevent or delay it through control of both blood glucose and blood sugar levels.

Symptoms of Diabetic Nephropathy

Diabetic Nephropathy doesn’t show symptoms early on. During the later stages, when kidney damage becomes severe, you may notice-

  • Upset stomach
  • Protein in the urine
  • Swelling of feet and ankles
  • Frequent urination
  • Confusion and difficulty in concentrating
  • Loss of appetite
  •  Nausea & vomiting
  • Weakness
  • Fatigue Weight loss
  • Insomnia and difficulty sleeping

Diabetic Neuropathy

Nerve damage that happens in individuals with diabetes resulting in severe foot issues is Diabetic Neuropathy. Over time, high blood sugar levels within the blood may injure your nerves throughout the body. This complication of diabetes most frequently damages nerves in your feet.

Causes of Diabetic Neuropathy

  • High levels of triglycerides
  • Hypertension
  • Genetic factors 
  • Smoking and substance abuse 
  • Chronic liver or nephropathy
  • Deficiency of vitamin B

Diabetic Sleep Disorder

Sleep disturbances are common among people with diabetes. Common sleep disorders include sleep apnea, restless leg syndrome and insomnia (difficulty falling and/or staying asleep). Persons with diabetes report higher rates of sleep disorders, poor quality of sleep, excessive drowsiness throughout the day, and enhanced use of sleeping pills.

Causes of Sleep Disorders in Diabetes

Multiple factors might contribute to sleep disorders in persons with diabetes including-

  • Discomfort or pain related to peripheral neuropathy
  • Restless legs syndrome or periodic limb movements
  • Rapid changes in blood sugar levels at night resulting in hypoglycemic and hyperglycemic episodes.
  • Nocturia and associated depression

Symptoms of Diabetic Sleep Disorders 

  • Difficulty falling or staying asleep
  • Feeling overly drowsy throughout the day
  • History of snoring 
  • History of apnea episodes 
  • History of uncomfortable sensations within the legs in the evening that are eased by movement.

Prevention of Sleep Disorders

  • Creating a routine sleeping and waking time
  • Eliminating stimulants like sugar and caffeine from food and drink on the brink of bedtime
  • Ensuring a cozy and quiet sleep atmosphere
  • Making sure loud noises are often contained, bright lights dimmed 
  • Avoiding stimulating activities right before bed, together with work, exercise, watching TV or being active on your laptop
  • Including daily exercise or meditation in your schedule

Diabetic Foot Ulcers/ Poor Wound Healing

Diabetic foot ulcer is one of the severe complications of diabetes. It is an open sore or wound which is generally associated with neuropathy and is seen in approximately 15% of people with diabetes. When your blood glucose levels are high, skin does not heal properly or repair itself because of nerve damage. Even a small patch of broken skin can cause a foot ulcer.

Why do wounds heal slowly when you have diabetes?

When you get a cut or burn yourself, your body begins a three-stage process to repair the damaged skin. It starts with an immune response which causes the wound to become inflamed to prevent any infection. After that, new cells (a scab) form over the injured area and finally, scar tissue forms to heal the wound.

However, high levels of blood glucose caused by diabetes can, over time, affect the nerves (neuropathy) and lead to poor blood circulation, making it hard for blood – needed for skin repair- to reach areas of the body affected by sores or wounds. This can cause them to remain open and unhealed for months, increasing the risk of fungal infections, bacterial infections and gangrene.

Diabetes & Amputation

When foot ulcers do develop, it’s important to get the right kind of care. Over 80 percent of amputations begin with foot ulcers. A slow or non-healing ulcer that causes severe damage to tissues and bone may require surgical removal (amputation) of a toe, foot or part of a leg.

Factors that lead to an increased risk of amputation include:

  • High blood sugar levels
  • Smoking
  • Nerve damage
  • Foot deformities
  • A history of foot ulcers
  • A past amputation
  • Kidney disease
  • High blood pressure

Gastrointestinal Disorders

Gastrointestinal (GI) problems or gastrointestinal disorders are significantly common in patients who suffer from type 1 and type 2 diabetes. Gastrointestinal Disorders involve problems in the gastrointestinal tract, namely the esophagus, stomach, small intestine, large intestine and rectum, and the accessory organs of digestion which include the liver, gallbladder, and pancreas. The entire GI tract can be affected by diabetes; from the oral cavity and esophagus to the large bowel and intestines.

Symptoms of Gastrointestinal Disorders

  • Reflux
  • Heartburn
  • Reduced appetite 
  • Abdominal bloating
  • Constipation
  • Abdominal pain
  • Nausea/Excessive vomiting
  • Weight loss
  • Diarrhea

Many patients go undiagnosed and under-treated because the GI tract has not been traditionally associated with diabetes and its complications. This can lead to severe consequences and pain for the patient. It’s advised to always take precautions and check for any symptoms regularly in order to avoid severe consequences.