Young With Diabetes? You May Be at Increased Risk of Alzheimer’s

May 29, 2024

Young people with diabetes may be at increased risk for developing Alzheimer’s disease later in life, according to a new study. The findings are particularly concerning because rates of diabetes are rising in young people and are projected to increase dramatically in the coming decades.
Most children and young adults with diabetes have type 1 disease, in which the body doesn’t produce enough insulin, the hormone that regulates blood sugar levels. There’s no know way to prevent type 1 diabetes, though it can be treated with insulin.
A growing number of young people, however, are developing type 2 diabetes, in which the body loses the ability to respond to insulin over time. Most type 2 diabetes cases occur in older adults, and obesity increases the risk. Rising rates of obesity in children may account for the growing incidence of the disease in young people. By some estimates, more than half a million Americans under 20 could develop type 2 diabetes by 2060, accounting for more than a third of the type 2 cases in young people.
In the new study, researchers found that young people with diabetes, either type 1 or type 2, had specific markers consistent with the brain degeneration typical of Alzheimer’s disease. The young people did not have memory loss or other symptoms of dementia, but over decades, the brain changes indicate an increased risk of developing full-blown Alzheimer’s disease.  
“Preliminary evidence shows that preclinical Alzheimer’s disease neuropathology is present in young people with youth-onset diabetes,” said the study’s lead author Allison Shapiro, assistant professor of pediatrics and endocrinology at the University of Colorado School of Medicine. “These preliminary data suggest the potential for an early-onset Alzheimer’s disease risk trajectory in people diagnosed with diabetes in childhood or adolescence.” The findings were published in the journal Endocrines.
The study was small, involving about 80 participants who were assessed as adolescents and later as young adults in their 20s. Some had type 1 diabetes, some had type 2, while controls did not have diabetes. 
Compared to controls, young people with diabetes, either type 1 or type 2 disease, had higher levels of blood markers typical of Alzheimer’s disease. In addition, “those with youth-onset diabetes showed elevated accumulation of amyloid proteins in areas of the brain where Alzheimer’s disease occurs,” Dr. Shapiro said. As levels of beta-amyloid increase in the brain, the toxic protein can clump together to form the telltale plaques of Alzheimer’s disease, killing brain cells in the process.
Most studies investigating the connection between Alzheimer’s disease and diabetes have focused on adults over 40. Older adults with diabetes have a 60 to 80 percent greater likelihood of developing Alzheimer’s disease and other forms of dementia compared to their peers without diabetes. Though, many people with diabetes never develop serious memory problems.
Diabetes may contribute to poor memory and diminished mental function in various ways. The disease damages tiny blood vessels throughout the body, including the eyes and feet. Ongoing damage to blood vessels in the brain may be one reason why people with diabetes are, as a group, at higher risk of cognitive loss as they grow older. Diabetes is also marked by impairment in the body’s ability to regulate blood sugar (glucose), which in excessive amounts may damage brain cells. The combination of diabetes and obesity can also contribute to high levels of body-wide inflammation, which researchers increasingly believe is tied to Alzheimer’s disease and other chronic diseases of aging.
The findings underscore the importance of keeping weight down, following a regular exercise regimen, and maintaining other lifestyle measures designed to keep the body, and brain, healthy into old age. A “heart-healthy” lifestyle may not only protect the heart and ward off diabetes; it may help to keep Alzheimer’s at bay as well, a growing body of evidence shows. 
If you already have diabetes, it is important to maintain tight control of blood sugar, using medications and regular medical check-ups. Other studies have shown that those with diabetes who ae not taking medicines for their disease are more likely to progress to Alzheimer’s disease than those who were not taking drugs for the condition.
By ALZinfo.org, The Alzheimer’s Information Site. Reviewed by Eric Schmidt, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University.
Source: Allison L. B. Shapiro; Christina Coughlin; Brianne M. Bettcher; et al: “Biomarkers of Neurodegeneration and Alzheimer’s Disease Neuropathology in Adolescents and Young Adults with Youth-Onset Type 1 or Type 2 Diabetes: A Proof-of-Concept Study.” Endocrines, May 6, 2024

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