Can diabetes cause dementia?
What you should know is that diabetes is associated 1.5-2 increased risk of dementia and cognitive decline especially with increasing age. Researchers think there is a higher association with vascular dementia rather than Alzheimer’s dementia.
dementia
Diabetes causes your blood sugar levels to be higher than normal. Normally, the pancreas produces a hormone called insulin to decrease the increased glucose levels. Now what happens in diabetes type 2 is your body fat cells, liver cells and muscle cells do not respond well to insulin. This is also called insulin resistance.
The higher blood sugars are associated with increased risk of dementia. In other words, the higher your blood sugar levels are the higher the risk of cognitive decline. One study also correlated very severe low glucose levels (also called hypoglycemia) with an increased risk of dementia. So, make sure you are taking care of your blood sugars.
All this this makes sense. Your brain cells need sugar to function and if there is too much sugar or too little sugar, they don’t work that well. If there are prolonged episodes of high blood sugar or low blood sugar this in turn damages your brain cells.
Now, to the main question. Can Metformin cause Dementia?
Metformin can cause B12 deficiency. If you want to find out more about read my article on metformin and B12 deficiency.
Vitamin B12 deficiency affects your brain cells and nerve cells. The protective covering around your nerve fibers called myelin is damaged.
This causes a variety of symptoms such as dementia, forgetfulness, insomnia, depression, irritability, peripheral sensory deficits, and psychosis.
B12 deficiency results in an increase of an amino acid in your blood called homocysteine. Elevated levels of homocysteine lead to brain shrinkage. Doctors refer to this as brain atrophy. When we get older our brain shrinks. However, with neurodegenerative diseases such as Alzheimer’s disease this is accelerated. In Alzheimer’s disease as well as other neurodegenerative disease homocysteine levels are elevated. Elevated homocysteine levels increase the risk of neurodegenerative diseases. Therefore, when taking your Metformin make sure your B12 levels are checked given that it can cause B12 deficiency.
memory
In the past years they have been some studies showing Metformin slowed down cognitive decline. A recent Australian study, just published in November of 2020 in the journal Diabetes Care, concluded older adults receiving Metformin have slower cognitive decline and dementia risk. That is quite a statement and stunning headline, don’t you think.
This study was, however, an observational study. Observation studies cannot prove that one thing causes another, only that they are linked. The study authors did write that larger more randomized studies in people with and without diabetes should be performed. In my opinion we have to be careful drawing any broader conclusions regarding these studies and other recent similar studies as they are NOT the gold standard of studies. The gold standard are randomized controlled studies. What I would conclude is that if your blood sugars are better controlled with diet and lifestyle changes including taking your diabetic medications to achieve better blood glucose control that these measures contribute to decreasing cognitive decline and decrease the chances of dementia..
Have a good day and Think your Health! Check entire video here.
Sources:
- Uptodate.com/Metformin
- https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020357s037s039,021202s021s023lbl.pdf
- .Metformin and the Risk of Dementia in Type 2 Diabetes Patients https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6345339/
- Critical levels of brain atrophy associated with homocysteine and cognitive decline https://pubmed.ncbi.nlm.nih.gov/24927906/
- Metformin Use Is Associated With Slowed Cognitive Decline and Reduced Incident Dementia in Older Adults With Type 2 Diabetes: The Sydney Memory and Ageing Study https://care.diabetesjournals.org/content/43/11/2691
