Q&A with Elizabeth Seaquist, MD, professor of medicine, University of Minnesota Medical School's Division of Diabetes, Endocrinology and Metabolism.
Q. How does type 2 diabetes affect memory?
A. Studies show that people with type 2 diabetes are at increased risk for Alzheimer's disease. They're also more likely to get vascular dementia -- memory loss caused by blood vessel damage and poor blood flow to the brain. And, they're at greater risk for mild cognitive impairment, memory problems that can sometimes lead to Alzheimer's disease. Yet we don't know exactly why people with diabetes are more likely to develop memory loss.
We do know that diabetes damages blood vessels and increases the risk for stroke, which can make you more likely to get vascular dementia. The connection might also have to do with insulin resistance. In people with diabetes, the body doesn't respond well to the hormone insulin, which normally moves sugar from the bloodstream into the cells. Some scientists believe that people with diabetes may also have insulin resistance in their brain. We need insulin to keep our brain cells healthy, and insulin resistance could damage brain cells enough to cause memory loss. In fact, researchers are investigating whether an insulin nasal spray might help ward off dementia.
If you have diabetes, keep your blood sugar under control to protect your blood vessels and prevent complications like nerve damage, kidney disease, and vision loss. Yet you don't want to overcorrect. Very low blood sugar can also harm your memory and mental function. Work with your doctor to keep your blood sugar within a healthy range.
You also want to stay on top of your cardiovascular disease risks, because heart and blood vessel problems can contribute to memory loss. Watch your blood pressure and make sure your cholesterol is well controlled.
And stay active. I'm a big believer that exercise is good for your health in general, and some studies of people who are at risk for Alzheimer's show that it can slow progression of the disease. Aim for at least 30 minutes a day of walking or other moderate-intensity exercise.
Finally, keep your body lean. I ask my overweight patients with type 2 diabetes to lose the excess weight and keep it off. Some studies show that obesity in middle age puts people at risk for memory loss later in life. Losing just 5% to 10% of your body weight can prevent diabetes, control your cardiovascular risk factors, and potentially preserve your memory. Losing weight through exercise and by eating balanced meals is one realistic step you can take to improve your brain function as you age.
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