糖尿病和痴呆风险:另一个控制血糖的好理由

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避免患糖尿病的原因有很多, or to keep it controlled if you already have it: Higher risks for heart disease, 中风和脚或腿截肢. 但这是另一个:它是痴呆症的主要风险因素.

而研究人员仍在调查导致风险增加的原因, one thing they do know is it's linked to highs – and lows – in the body's blood sugar levels.

“无论是1型还是2型糖尿病, 血糖控制对保持大脑健康非常重要, 瑞秋·惠特默说, 加州大学流行病学系主任, Davis and associate director of the school's Alzheimer's Disease Research Center. “这是另一个良好控制的动机."

Good management of blood glucose levels is one of seven lifestyle changes people can make to support better heart and brain health, 叫做《简单人生 美国心脏协会. 这一步骤可能会帮助超过34人.在美国有200万人.S. 糖尿病患者的生活.

根据美国疾病控制与预防中心的数据, 绝大多数糖尿病患者都是2型糖尿病, 随着人们年龄的增长，哪一种会变得更普遍, 痴呆也是如此. It happens when the body can't properly use the insulin it makes to control blood sugar levels. It develops over many years and is often associated with being overweight or obese. Type 1 diabetes is an autoimmune disease in which the body stops making insulin.

Most of the research on the diabetes-dementia link involves Type 2 diabetes, which 研究显示 roughly doubles the dementia risk and may cause it to develop a few years earlier. 对于1型糖尿病患者, 治疗方法的进步延长了人们的寿命, allowing researchers to begin delving into how the disease affects their cognitive abilities as they age.

"They are now living to ages to be at risk for diseases that happen later in life,"

惠特默说, who is also an adjunct investigator at the Division of Research for Kaiser Permanente Northern California.

Whitmer 领导了一项研究 for Kaiser that showed older adults with Type 1 diabetes who were hospitalized for just one blood sugar extreme were at higher risk for dementia – and those who were hospitalized for both highs and lows were six times more likely to later develop dementia.

香农Macauley, an assistant professor of gerontology and geriatric medicine at Wake Forest School of Medicine, studies the relationship between Type 2 diabetes and Alzheimer's disease in her lab in Winston-Salem, 北卡罗莱纳.

“葡萄糖对大脑非常重要，”麦考利说. Though it makes up just 2% of the body's weight, the brain uses 20%-30% of circulating blood glucose. "People don't appreciate how much the brain sucks glucose out of the blood; it's a big user of your glucose supply."

她说，与其他器官不同，大脑不能储存多余的葡萄糖. 这使得它容易受到高点和低点的影响. "It needs it on demand in a rapid fashion but that puts the brain at excess risk when glucose levels hit one extreme or another."

Macauley的 对老鼠的研究表明 过多的葡萄糖可能会导致淀粉样蛋白的快速生成, 在大脑中聚集在一起形成淀粉样斑块的蛋白质. β -淀粉样蛋白与阿尔茨海默病的发展有关.

当大脑突然产生过量的-淀粉样蛋白时, 这“就像在I-95号州际公路上扔了一个泽西屏障。,麦考利说. “所有的汽车都必须想出如何绕过它. 细胞无法到达它们需要去的地方, 它们不能与其他细胞正常交流，从而失去效率."

相反, too little glucose in the brain robs it of the energy it needs to perform tasks, 她说. “你手头上的每一件事都需要精力——说话、思考、扣衬衫. 能量也用于维持细胞和大脑的活力. If you go low, you are starving the brain, and it can't do what it needs to do."

Preventing dementia isn't the only way good blood glucose control helps the brain, 惠特默说.

“这也有助于预防中风，”她说. “大脑中有很多血管. 良好的血糖控制等同于良好的血管健康. 对心脏有益的东西对大脑也有益."

一个人是否患有1型或2型糖尿病, 他们可以采取很多措施来保持血糖水平稳定.

首先，了解你的数字是很重要的. Even blood sugar levels slightly higher than normal – a condition known as prediabetes – can start to do damage, Macauley说. 在健康范围内, 水平应低于100毫克/分升, 如果测量值在100-125毫克/分升，则认为是前驱糖尿病.

"If you are in that realm, there are clues you are becoming unhealthy,麦考利说. 一个人可能超重, 饮食不健康, 吸烟或睡眠不足或体育锻炼不足. “运动会让你消耗多余的葡萄糖."

她说，如果饮食和运动不起作用，可能需要药物治疗.

People with Type 1 diabetes need to check blood sugar levels throughout the day because what they eat and how much physical activity they get can cause levels to rise or fall. 健康专家建议他们保留硬糖等补给品, fruit juice or glucose tablets with them to boost levels should they get too low.

因为1型糖尿病患者寿命更长, 惠特默说, researchers need to focus on other ways to ensure their years are healthy ones. "We really need to step back and think about how we can increase this patient population's chances of successful aging."

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