Prediabetes Might Hurt Your Mind

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By Ernie Mundell and Robert Preidt

HealthDay reporter

WEDNESDAY, February 17, 2021 (HealthDay News) – “Prediabetes” – where blood sugar levels are high but not yet turned into full blown diabetes – could pose a threat to brain health, according to new UK research.

“As an observational study, it cannot be shown that higher blood sugar levels lead to deterioration in brain health. However, we believe that a possible link needs further investigation,” said study director Victoria Garfield. She is with the Institute of Cardiovascular Science and the MRC Department of Lifelong Health and Aging at University College London.

In their research, Garfield’s team analyzed data from the UK biobank on half a million people, the mean age of 58 years. Compared to people with normal blood sugar (“glucose”) levels, people with prediabetes had, on average, a 42% higher risk of mental decline by the age of four and a 54% higher chance of developing vascular dementia – a common type of dementia, caused by decreased blood flow to the brain – over an average of eight years.

The associations between prediabetes and mental (“cognitive”) decline / vascular dementia persisted even after the researchers considered other potential risk factors such as age, smoking, weight, degrees of heart disease, and poverty.

Prediabetes was not linked to an increased risk of Alzheimer’s, Garfield’s team found.

A US diabetes expert said the results weren’t surprising given that doctors have long known that full-blown diabetes increases the risk of dementia.

“The result is that the cognitive risk associated with elevated glucose levels appears on a spectrum,” said Dr. Minisha Sood, an endocrinologist at Lenox Hill Hospital in New York City. Even in the prediabetic stage, “when the body overproduces insulin to maintain normal blood sugar levels,” brain damage could be underway, she said.

Sood believes that people who are in a prediabetic condition should be warned of the dangers by their doctors.

The UK team also looked at people with full-blown type 2 diabetes and found that they were three times more likely to develop vascular dementia and Alzheimer’s disease than people with normal blood sugar levels.

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The study was recently published online in the journal Diabetes, Obesity, and Metabolism.

“Previous research has found a link between poor cognitive outcomes and diabetes, but our study is the first to look at how relatively high blood sugar, but not yet diabetes, affects our brain health,” Garfield said in one University press release.

Dr. Barbara Keber is the Chair of Family Medicine at Glen Cove Hospital in Glen Cove, NY. Reading the new findings, she said it “makes sense” that prediabetes could affect blood flow to the brain because it does the same thing elsewhere in the body.

However, Keber also noted that overly tight glycemic control in patients has been linked to hypoglycemia (dangerous drops in blood sugar levels), which has also been linked to “increased risks of developing cognitive decline and dementia”.

“So the takeaway here is that we need to prevent prediabetes and diabetes and control glucose levels for those diagnosed without causing hypoglycemia to prevent cognitive decline and vascular dementia from developing,” said Keber.

In the meantime, even the average person with prediabetes can do a lot to get rid of this threat to their health.

“For the lay population, they must follow a diet that reduces their risk of developing diabetes, exercise regularly – both isometric (strength training) and aerobic (cardiac exercise) – to reduce weight gain and prevent the development of prediabetes and diabetes prevent diabetes, “said Keber.

More information

The American Academy of Family Physicians is more concerned with prediabetes.

SOURCES: Barbara Keber, MD, Chair, Family Medicine, Glen Cove Hospital, Glen Cove, NY; Minisha Sood, MD, endocrinologist, Lenox Hill Hospital, New York City; University College London, press release February 11, 2021

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