I came across LinkedIn a study published only a couple of days ago titled Diabetes, Prediabetes, and Brain Aging: The Role of Healthy Lifestyle. A bit of background as to why the results of this study are exciting. We know that diabetes is a risk factor for dementia, so they examined the difference in the brains of healthy, pre-diabetic and diabetic participants. They did so by looking at MRIs and also further splitting the participants based on their lifestyle.
Methodology
Methodology wise, they used the UK Biobank dataset selecting more than 30k dementia-free adults aged 40 to 70. Their diabetic / glycemic status was determined based on their past medical history, medication, and HbA1c measurements, aka blood sugar levels. They also looked at lifestyle behaviours, this included the typical smoking, alcohol, and exercise questions, as well as general health information like whether they were obese, had high blood pressure, low HDL (the good cholesterol), or high triglycerides (the fat in your blood).
Optimal lifestyle participants (aka healthy) were classified as non smokers, no heavy drinkers, and high physical activity. If otherwise, they were classified as non-optimal lifestyle.
So all of the participants were split into the following categories Normoglycemia (no diabetes) + optimal or nonoptimal lifestyle, Prediabetes + optimal or nonoptimal lifestyle, Diabetes + optimal or nonoptimal lifestyle.
Then each participant had 2 MRI scans done over an 11-yr follow up period. Now, using the imaging and a machine learning model they estimated brain age, and thus the brain age gap, i.e., the difference between the chronological age (true age) and the brain age outputted by the model. This was based on 1,079 brain MRI phenotypes.
Results
They found that even pre-diabetics had a positive brain age gap of 0.5 yrs, meaning their brain was 1/2 a year older than their chronological age. Similar patterns were also seen for the diabetics, where the brain age gap increased based on the HbA1c levels.
Diabetics with HbA1c < 7% had +1.7 yrs
Diabetics with 7% < HbA1c < 8% had +2.5 yrs
Diabetics with HbA1c > 8% had +4.2 yrs
Although some of these numbers may not seem that great, if you assume the diabetic person is 40 years old with HbA1c > 8%, that means +4.2 yrs added to their brain which is 10% of their chronological age!
The trend they found between HbA1c and brain age gap (BAG) looked almost linear. You can see it from the graph below on the right hand side. So clearly there is an association between diabetes with brain ageing.
What they also reported was that diabetes was also linked to a significant annual increase in BAG, indicating ongoing brain ageing. This highlights that diabetes has an impact over time, and it’s not a “one-off”.
When it came to sex, they reported that the association between (pre)diabetes and higher BAG was stronger in men and in individuals with multiple cardiometabolic risk factors.
Now lifestyle wise, a healthy lifestyle was found to significantly reduce the negative impact of diabetes on brain ageing. For instance, individuals with diabetes who maintained a healthy lifestyle had a BAG of only 0.78 years, compared to 2.46 years in those with a non-optimal lifestyle.
Overall, the study did also highlight the importance of lifestyle modifications in potentially counteracting the adverse effects of (pre)diabetes on brain health. Also underscoring the need for targeted interventions to promote brain health in these populations.
Diabetes has always been considered as a comorbidity due to the damage to large and small blood vessel, which can lead to kidney failure, blindness, cardiovascular issues and more. It’s fascinating how we can further quantify the impact of it on the brain with respect to ageing, which also once again highlight the importance of a healthy lifestyle to counteract the adverse effects even if one is a diabetic. Even if you are diabetic, lifestyle modifications can still be made to keep the disease under control but also minimise the adverse effects due to it.
I hope you enjoyed, thank you for taking some time out of your day to read to my post! If you did, click on the ❤️ button below. See you next week! :)
Sara
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Every single fucking week I learn something so profound. Your newsletter is one I look forward to so much.
BRB while I go tell my fiancé he REALLY needs to go get tested for diabetes 😤 🙄 😒
Great information Sara. It makes so much sense. What we fuel our bodies with and will effect our brains. Good or bad. A lot can be taken from this in the aspect of the new term ‘type 3 diabetes’. Where researchers are linking high glucose levels to people with Alzheimer’s and dementia.