Having diabetes can cause a host of complications beyond just blood sugar. So can being overweight or obese. For patients who are both obese and diabetic (specifically adult onset Type 2 diabetes) the combination of both of these problems can actually alter the brain according to new research. The European Association for the Study of Diabetes [EASD]) reveals that overweight and obese individuals with early stage type 2 diabetes (T2D) had more severe and progressive abnormalities in brain structure and cognition compared to normal-weight study participants.
The study was conducted by by Dr Sunjung Yoon and Dr In Kyoon Lyoo (Ewha Brain Institute, Ewha Womens University, Seoul, South Korea), Hanbyul Cho (The Brain Institute, University of Utah, Salt Lake City, UT, USA) along with colleagues in Korea and the United States. Study participants were a group of 150 Koreans between the ages of 30 and 60. They were broken into groups of 50 overweight/obese individuals with T2D, 50 normal-weight individuals with T2D, and 50 normal-weight healthy individuals without diabetes.
Multiple research studies have already proven that Type 2 diabestes affects the brain and while the exact way this happens has yet to be fully mapped out, metabolic issues in T2D like out of control blood sugar and A1C levels, insulin resistance and inflammation are thought to be part of the problem. Obesity is definitely related to the onset of Type 2 diabetes as well being linked to metabolic dysregulation, so researchers wanted to investigate the combination of these factors to see if the brain was at an increased risk when both conditions were present.
Participants in the study were matched for age and sex as well as disease duration. MRI studies were conducted to measure the mean thickness of the cerebral cortex. Thinning of this part of the brain is associated with dementia and cognitive decline. In addition to scans the volunteers took cognitive tests to measure their executive function, memoryand psychomotor speed. The MRI images showed that grey matter was noticeably thinner in the temporal, prefrontoparietal, motor and occipital cortices of the brains of diabetic patients as when compared to the healthy control group. This thinning was even more pronounced in the group of overweight and obese diabetics when compared to diabetics of normal weight. In one area of the brain, the temporal lobe, thinning of the cortex was most significant in those patients who were both overweight/obese and diabetic. The temporal lobe is one of the most commonly affected parts of the brain in patients with Alzheimer’s disease and other forms of dementia, so seeing this kind of damage among patients who were both overweight and diabetic was significant to researchers who warned that failure to control blood sugar and weight could have serious risks to the brain.
The authors of the study wrote, “Our findings also highlight the need for early intervention aimed to reduce risk factors for overweight or obesity in type 2 diabetic individuals to preserve their brain structure and cognitive function.” This could include earlier use of insulin and other interventions. While many physicians believe it’s best to hold off on placing their diabetic patients on insulin until absolutely necessary, this new information, especially for patients with the additional risk of being overweight, could change that way of thinking. The video below details more about the study and how to avoid increasing your risk if you have diabetes or are overweight.
Sources: European Association for the Study of Diabetes, Diabetologia, CNN