According to a new study published three days ago in the Journal of Alzheimers Disease an NYU researcher discusses the pathway between diabetes and Alzheimers. It have long been known that there is a strong association between the two conditions but the details were unclear. This discovery can help guide healthcare providers and patients on how Alzheimer's may be prevented.

The author compared decades of research on diabetes and Alzheimer's disease. The main mechanisms that connects the two diseases are insulin and the enzymes that break it down. These same enzymes that break down insulin also break down amyloid-beta which is the protein that forms tangles and plaques in the brains of people with Alzheimer's disease. When people have hyperinsulinemia they produce too much insulin due to a poor diet prediabetes early diabetes obesity metabolic syndrome etc. As a result these enzymes are too busy breaking down insulin to break down amyloid-beta causing amyloid-beta to accumulate. 

According to estimates from the American Diabetes Association approximately 8.1 million Americans have undiagnosed diabetes and 86 million have prediabetes and are unaware of this. I shared a study just last month in the Journal of the American Board of Family Medicine where only 1/4 of patients who were prediabetic received lifestyle recommendations from their primary care physician. This is the missed opportunity for diabetes prevention reducing the risks of Alzheimers and dementia and for the overall health of the patient. 

The good news is that hyperinsulinemia is preventable and reversible through dietary changes lifestyle changes exercise and proper nutrient support. If we address the epidemic of metabolic syndrome prediabetes and obesity we could significantly reduce the risk of Alzheimer's disease and dementia as well as the many complications that come along with diabetes.

It is important to test every patients A1C levels are on regular basis. Hyperinsulinemia is linked to insulin resistance and obesity; weight loss and exercise are considered the best treatments.

It is important that the patient limits carbohydrate intake and consumes a low glycemic load diet that is high in fiber and low in sugars and flour. A healthy diet turns on the right gene messages promotes a healthy metabolism and prevents insulin resistance and diabetes. 

In addition there are a variety of beneficial nutrients such as chromium zinc carnosine benfotiamine alpha lipoic acid and inositol. For those individuals who may need further support to reduce insulin resistance when these essential nutrients are not enough berberine should be considered. Berberine has metabolic effects very similar to metformin but also has significant effects on body composition (waist circumference and waist to hip ratio) and dyslipidemia which are not seen with metformin. Furthermore berberine has long been known for its antimicrobial properties which is another antidiabetic mechanism of berberine through modulating the gut microbiota. 

By Michael Jurgelewicz DC DACBN DCBCN