Question

Is the brain affected in diabetes mellitus?

In diabetes mellitus type 1 or 2 is the brain affected? And if it is, then why? I remember from biochemistry that the brain is an insulin independent tissue.

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  • Ru-Jeng Teng · Medical College of Wisconsin
    Good question. You might be right about brain is relatively insulin independent but however hyperglycemia can lead to vasculopathy which can affect brain function. Not to say DM tends to associate with high blood pressure and kidney damage which can also impair brain function. There are so many things happen in DM that can affect brain.
  • Hisham El Batawi · University of Sharjah
    I think DM affects the brain indirectly. The key here is to maintain acceptable blodd glucose level.
  • Miguel Castelo-Branco · University of Coimbra
    There are some animal studies studying the impact of diabetes on neural function and cognition. An important question is whether this is only related with vasculopathy. I think that there may be direct neural damage.
  • Camilo Andrés Tobón · CLINICA OFTALMOLOGICA DEL CAFE
    I suggest the article GLIA 55 1238 - 1250 (2007), there you can learn a little of the metabolism of glucose in the brain,
  • Samira Saleh · Cairo University
    Didi....This is a very good question because the impact of diabetes on the brain is actually overlooked. Theoretically, one can say that since diabetes affects so many organs in the body, therefore, it might affect the brain as well. Practically speaking, it has been shown that chronic hyperglycemia leads to the release of mediators that cause chronic brain inflammation, reduce blood flow and damage the cells. In fact hyperglycemia raises the risk of having dementia and depression. The chances of becoming depressed or getting dementia increases when diabetes complications develop and decreases in diabetic people with good blood sugar control. Besides, cardiovascular complications could contribute to stroke by blocking the blood flow to the brain.
    Another way in which diabetes can affect the brain is ketoacidosis, that occurs most likely in Type I diabetes, where the brain cannot handle the excessive amounts of ketone bodies. We must not forget that hypoglycemia, resulting from an overdose of antidiabetic drugs, leads to hypoglycemic coma.
    To keep away from all these problems GOOD BLOOD SUGAR CONTROL is very important.
  • Deleted
    Uncontrolled sugar levels obviously trigger on ketoacidosis since to meet the energy requirements of a vital organ like brain, it becomes a mandatory biological phenomenon. The chronic ketoacidosis may precipitate out brain damage. Vasculopathy is another complication as rightly pointed out by other experts. In the same breath, let me admit that also one should not overlook the diabetic neuropathy. Uncontrolled hyperglycaemia in long run leads to neuronal degeneration termed as diabetic neuropathy. In initial stages, peripheral neurons may be affected; however, the complication is progressive and may affect the higher centres in brain too. To summarize, the damage may be initially secondary but proceeds to affect the vital centres in brain. To put it poetically one can say that diabetes mellitus is a SYNDROME that affects adversely the entire body from tip of your hair to toe of your leg. Though relatively an old article, the following link will provide you the insight into the issue.
    http://www.sciencedirect.com/science/article/pii/S1474442203005039
  • Deborah Greiff · Cambridge College
    It is not just the integrity of the brain, as an organ, is affected by hyper and hypoglycemia and well as ketoacidosis, but the the cognitive functioning of the brain is greatly reduced. Children that have diabetes can have severe difficulties with academics if their blood sugar is not properly maintained. This, of course, can have lifelong ramifications reaching beyond the actual damage that diabetes has physically done to an individual.
  • Samira Saleh · Cairo University
    I agree with Tapan Shah and Deborah Greiff that diabetes may be an important factor for cognitive impairment.
  • Samira Saleh · Cairo University
    Samira Saleh · 26.25 · 54.24 · Cairo University
    I agree with Tapan Shah and Deborah Greiff that diabetes, whether Type I or Type II, may be an important factor for mild cognitive impairment. Many factors contribute to this; uncontrolled blood sugar levels, chronic hyperglycemia, chronic ketoacedosis, recurrent episodes of hypoglycemia, vascular and neural complications. The exact role of each of these variables is yet to be resolved.
  • Apart from the inflammatory mediators and the ketoacidosis of hyperglycaemia, worthy to mention the hypoglycaemic effects on brain as a result of treatment of these diabetics. Eventually, many nor most of the diabetic population will have experienced an occasional episode of moderate to severe hypo. Equally, many minor hypos might not have been reported. Such events could cumulate in terms as ill effects on the brain tissue
  • Abhilash Kannan · Kerala University of Health Sciences
    Atherosclerosis is a companion of diabetes which will cause small vessel disease in brain. There is increased risk of stroke in diabetic population. Hyperglycemia & hypoglycemia are dangerous to brain, more with hypoglycemic episodes. Recurrent hypoglycemia are thought to be linked to cognitive decline in future.
  • Eugene Pretorius · University of the Free State
    The brain functions on glucose primarily as source of energy (and during starvation ketones from degraded proteins) So DEFINITELY on the long run DM would effect the brain. During a hyperglycemic event one feels dizzy and a certain "buzz" affecting vision, this already shows how the increase of glucose in the blood can have adverse effects on the brain (consciousness). However the mechanics of long time exposure to high BG I do not know. I suppose the blood-brain-barrier should be able to control glucose uptake at any given time but constant high levels might affect its sensitivity.
  • Curt Brimacomb · Lewis-Clark State College
    since glucose use in the brain is higher than any other place In the body, if you reduce the glucose to the brain cells, they will produce lower levels of proteins, and you could get delayed brain development in the neural pathways and connections. so with children, you could get permanent cognitive damage? it would seem that blood glucose control would be more important in infants/children than with any other age group.
  • Carlos Contreras Quevedo · Petróleos Mexicanos
    Parece que no, una vez que la glucosa por sí misma no tiene contacto directo con el tejido. Lo hace a través de los GLUT 1 y GLUT 3. Son proteínas que regulan su actividad de acuerdo al consumo cerebral de glucosa requerido. Se regulan por citocinas y no por la insulina. Mi respuesta es interpretando que deseas saber si el tejido cerebral es el afectado, no su función. http://www.neurologia.com/pdf/Web/5112/be120745.pdf
  • Ahed Alkhatib · Jordan University of Science and Technology
    in one of my articles in my page at RG, I found brains of diabetic rats showed high expression of iNOS and low expression of HSP70. this implied a stress condition due to diabetes.
  • Carlos Contreras Quevedo · Petróleos Mexicanos
    But, is there a typical damage to brain cells? Not artery or veins.
  • Ahed Alkhatib · Jordan University of Science and Technology
    the expression of iNOS and HSP70 was found in brain cells in addition to vascular system
  • Carlos Contreras Quevedo · Petróleos Mexicanos
    Thank you Ahed, this was enriching.
  • Dhana Shakya, Dr. · B.P. Koirala Institute of Health Sciences
    Brain means not only its structure aspect but also its function. In our study in a Diabetes clinic, diabetic patients had high psychiatric co-morbidity (reference- https://www.researchgate.net/publication/228068418_Psychiatric_problems_in_patients_with_diabetes_mellitus_attending_a_diabetes_clinic_at_a_tertiary_care_hospital_in_Eastern_Nepal?ev=pub_cit) as in other studies. And, those diabetic patients with psychiatric co-morbidity had significantly more Diabetic neuropathies, cardiovascular complications, and morbid obesity than those diabetic patients without mental illness (reference- https://www.researchgate.net/publication/257634128_Comparison_of_complications_in_diabetic_outpatients_with_or_without_mental_illness); all with direct or indirect effect in brain. Besides biological consideration, we should not forget psychological and social factors associated with this chronic morbidity when we consider the effect of diabetes mellitus in brain.
  • One out of several reasons for co-morbidity is an increased level of homocysteine caused by diabetes medication biguanide which has the ability to steal vitamines B-9 and B-12. The re-methylation of homocysteine will not work properly . High homocysteine
    levels in blood are causing depession-like symptoms (low mood) and hardening of arteries which may explain the cardiovascular complications Dhana reported. There are several ways out of this misery, for example a co-administration of B-vitamines (B-1 might be also helpful in diabetes): My personal choices would be a replacement of medication by almonds which reduce the free insulin without any side effects as well as cholesterol,.
    A good research report is published here :
    http://www.nature.com/ijo/journal/v27/n11/full/0802411a.html

    Table 3 is containing impressive results.

    Besides almonds are containing uridine which is a weak antidepressant without any known side effects..
    http://plantstemcells.wikispaces.com/Sweet+Almond+%E2%80%93+Prunus+Amygdalus#Uridine:

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