Diabetes and brain damage it’s like wireless connection!

Looking through the dangers of Type 2 diabetes, Doctor ensures life-threatening condition like heart disease, typical risk of stroke along with micro vascular complications such as Retinopathy, Nephropathy and Neuropathy. However diabetes can damage the brain directly—filling in the details of the gap in which insulin resistance and memory loss takes the prime criteria. While the deleterious effects of diabetes mellitus on the retinal, renal, cardiovascular and peripheral nervous systems are widely accepted though a less attention has been given to the effect of diabetes on cognitive function. Both Type 1 and Type 2 diabetes mellitus have been associated with reduced performance on numerous domains of cognitive function.

Life expectancy is increasing is a good news. The downside to this trend is that more and more people will develop diseases such as diabetes and some may even be unfortunate to be in a state of ‘buy one – get one’ fate. In fact, epidemiologic studies have shown having Type-2 diabetes increases the risk of developing Diabetes disease by 65% and that 80% of Diabetic patients have problems of glycemic control.

Meals, insulin and brain functions look alike within minutes of a meal, insulin is sent to the brain to help neurons absorb and use glucose. Smaller increases in insulin also occur throughout the day, likely in response to neural signals. In the brain, insulin has a number of roles to play. It promotes glucose uptake in the neurons of the hippocampal formation and the frontal lobes, areas that are involved in memory. Insulin also strengthens the synaptic connections between brain cells, helping to form new memories. In addition, insulin regulates the neurotransmitter acetylcholine, which plays an important role in learning and memory. Finally, insulin is involved in blood vessel formation and function.

Brain insulin resistance means when insulin and related growth proteins in the brain are vital for cell survival and both glucose and insulin appear to regulate many brain functions, including learning and memory. Dysfunction of these chemicals contributes to cognitive deficits. Chronic episodes of high or low levels of blood glucose may directly affect insulin’s actions in the brain or damage brain cells leads to cognitive impairments. New evidence shows that the insulin-insensitive state found in our liver, fat and muscle cells/tissues corresponds with insulin sensitivity in our central nervous system, as well (insulin resistance at the level of brain). This impacts the areas of the brain responsible for cognition, memory and learning. Diabetes may be wreaking havoc especially in the hippocampus. The hypothalamus means in the brain region that regulates metabolic processes and activities like hunger, thirst, and body temperature; also appears to be involved especially areas that respond to low blood sugar and regulate energy balance, body weight and the sensitivity of the liver and muscles to insulin. Insulin is a process of memory formation at the cell level; it also regulates several of the chemical messengers involved in memory, such as acetylcholine. At low doses, insulin helps to contain inflammation and, at high doses, stimulates it. Increased insulin concentrations also appear to boost levels of beta-amyloid which is known as a protein involved in the formation of senile plaques that can lead to diabetic disease. Because inflammation, reduced acetylcholine and toxic accumulations of beta-amyloid protein are hallmarks of the disease, insulin insensitivity is one route through which this disease may develop.

Those suffering from Type 2 diabetes and insulin resistance also run a heavy risk of developing impaired memory cognition and increased risk for dementia or memory loss and developing diabetec disease. Insulin regulates the brain’s supply of dopamine which is a neurotransmitter which helps in attention, reward and motor activity and any disruption or abnormality in insulin’s action can lead to brain disorders and cognitive imbalances in mood and disorders like depression.

Two-way scientific and treatment benefits: There is mounting evidence that scientists from the metabolic and central nervous system (CNS) fields must unite and look at neurodegenerative processes from a different angle, taking into account the evidence generated whilst studying metabolic diseases. Conversely, knowledge generated in CNS labs could contribute to innovative ways to prevent and treat metabolic diseases. Here are some questions that scientific brains and hands together address: a) How can metabolic states affect brain function? b) How can CNS targets expressed in the periphery regulate metabolism? c) How can anti-diabetic compounds contribute to preventing and treating neurodegenerative diseases?

An ‘executive’ could lose executive function: Since diabetes impairs planning, coordinating, sequencing, and monitoring of cognitive operations, collectively known as ‘executive function’, the so-called ‘business executive’ being a diabetic could end up with loss of executive function. Therefore, it’s important to prevent cognitive decline. Evidence from neuro-cognitive testing suggests that cognitive dysfunction should be listed as one of the many complications of diabetes. Recently, it is also emphasized that clinicians should consider cognitive function in assessing and guiding their patients regarding safe diabetes self-management regardless of their glycemic targets. If someone asks what’s special about Dr. Abhyudaya Verma Diabetes Speciality Centre – the answer is this – holistic treatment beyond just glucose control – where the doctor treats physical, metabolic, mental, psychosocial and behavioral aspects of the patient.

The same slogan: ‘prevent and control diabetes with appropriate lifestyle modification and live a healthy life’, the same wine (message) in a new bottle (evidence). The ‘voice’ should now reach beyond ears – right up to the brain for better cognitive function and best quality of life.

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Diabetes and Exercise

Diabetes has increased substantially, particularly in India. The pandemic is expected to reach even greater proportions in the future. Genetic and environment factors are of equal importance in causing diabetes. While, genetic factors are beyond our control, lifestyle modifications, complemented by pharmacological interventions can help in modifying the environmental factors. It is well recognised that modernisation and industrialisation have resulted in drastic changes in lifestyle, unhealthy diet habits and physical inactivity.

It is known that physical activity is important for everyone’s health and it can be especially important if one has diabetes. The therapeutic use of exercise for diabetes was prescribed during the course of a period, which dates back to as early as 600 BC. Today, exercise is recognized as an essential part in the Management of Diabetes. Exercise, if done regularly, it will help people with diabetes to live a healthy life despite of any disorder. However, as it is totally patient dependent as it is often the most neglected aspect of management of diabetes.

Role of physical activity

Regular physical activity is very essential and an important part of effective weight maintenance as it improves overall health. It is the most cost-effective medicine. It does not matter what type of physical activity one performs – sports, planned exercise, household chores, garden work or work-related tasks, all the things are beneficial. Today in the technological advancement system led to a sedentary lifestyle compared to earlier days when a fair amount of physical activity was involved. Walking and cycling have been reduced as people move around in cars and buses. Microwave ovens and mixers have replaced manual cooking and grinding. People are addicted to television and internet and rather than socializing, they now ‘meet’ neighbor over calls or text in Mobiles. Hence, one should make it a daily challenge to find ways to move one’s body. One can think of ‘move’ in small increments of time. It doesn’t have to be an hour in the gym or a 45-minute aerobic class.

Benefits of physical activity

The benefits of exercise are far sighted. Clinical and epidemiological studies have demonstrated that regular exercise helps prevent and controls diabetes mellitus, reduces the risk of death due to heart disease and stroke, aids in reducing weight, reduces colon cancer, strengthens bones, muscles and joints, enhances immune system, increases stamina, lowers blood pressure, aids digestion, reduces serum lipid levels, improves blood circulation, provides skin a healthy glow and may add a few years to life.

Some of these benefits include:1) Lowering blood sugar, blood pressure and blood fats 2) Increasing oxygen levels in the body 3) Aiding weight loss 4) Reducing stress 5) Strengthening the heart, muscles and bones 6) Improving blood circulation 7) Toning muscles.


There are hundreds of excuses not to exercise. Too busy, too tired, too bored, no room for equipment, no place to exercise, can’t afford club fees, bad health; the list is endless. Excuses provide an easy way out to avoid exercising. The faster you work towards eliminating those excuses, the closer you’ll be to living a healthier, more active life. Eventually, exercise won’t be a chore – it will be the reward your body’s been craving.

If time is your enemy, re-evaluate your schedule

Instead of spending 30 minutes sitting in front of the television at night, do on the spot jogging or walk on your treadmill as you watch your favorite show. Remember you don’t have to exercise all at once. Break your workout into two 15-minute sessions or three 10-minute sessions and do them throughout the day.

If you’re too tired (or lazy) to exercise, get moving

Fatigue can actually be caused by a sedentary lifestyle. Exercise will help jump-start your body. Start slowly, and over time, exercise will increase your energy level while decreasing fatigue. One can tailor the exercise programme to one’s life style.

No place to exercise? Find one

You don’t need a park, a playground or beachside to do exercise. One can select activities which can be done at sites convenient for you which can be an outdoor or indoor activity. These may be around the house or on the terrace or even in a small room where spot jogging can be done. It is not the place that matters, but the consistency with which you do it.

Aches and pains? Reprogram your thinking

Initially when starting an exercise programme, there might be some pain which is due to accumulation of lactic acid in the muscles. In due course, the pain will disappear as one follows a proper exercise regime. However, if any exercise hurts too much you should stop and consult your doctor.

Exercise checklist for people with diabetes

1) Talk to your doctor about the right exercise for you. 2) Check your blood sugar level before and after exercising. 3) Check your feet for blisters or sores before and after exercising. 4) Wear the proper shoes and socks. 5) Drink plenty of fluids before, during and after exercising. 6) Warm up before exercising and cool down afterward. 7) Have a snack handy in case your blood sugar level drops.

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