ALZHEIMER’S - TYPE III DIABETES















Alzheimer’s disease is characterized by dementia. It is a disease of the brain which progressively affects thought process, abstract reasoning, memory, speech, ability to perform simple tasks, etc.  A validation of this neurodegenerative disorder  can only be made by autopsy of  the patient’s brain, which can reveal the associated neuronal loss or cell death. The causative agents are extracellular neuritic plaques and intracellular neurofibrillary tangles with abundance of amyloid precursor protein, viz, Beta-amyloid, primarily in the frontal and temporal lobes including hippocampus. These are insoluble deposits which result in disruption in synaptic circuitry, cerebral atrophy, ventricular enlargement and the consequential dementia. It is said that major loss of volume is observed in the temporal lobe. In more advanced stages, it can spread to other regions of the brain.

Research by neuropathologists at Rhode Island Hospital and Brown Medical School, has revealed that development of plaques and the resultant loss of neurons in Alzheimer’s Disease is because of abnormalities in insulin signalling.  Acetylcholine deficiency is said to cause dementia. Insulin and Insulin like growth factor (IGF-I) stimulate the production of an enzyme responsible for synthesising acetylcholine in the brain.  Because of the direct link between the two, Alzheimer’s is being recognised  as Type-III diabetes.
                       
Type-I diabetes results when the Pancreas cannot make insulin as the body’s own immune system destroys the insulin producing cells.  On the other hand,  when the Pancreas produce extremely small quantities of insulin or  when the body is unable to respond to insulin, it is termed Type-II diabetes.  Why is insulin so important can be understood from how it works in the human body. All the cells in the body require energy for functioning. In order to obtain energy  a large part of the food eaten is broken down to sugar called glucose. Blood stream does the job of transporting glucose to the cells for further usage as energy. Insulin mediates the transmission of glucose into cells for further use. Pancreas keep releasing insulin in little amounts into the blood. In case the blood glucose level rises, Pancreas increase the quantity of insulin in blood for its ultimate transport to the cells. In the opposite case, when blood sugar levels are low, the body signals us to eat and simultaneously the Liver releases glucose for compensating the requirement.
                                                                                                                               
Insulin expressed in the brain is a key factor for survival of the brain cells and formation of memories.  It is said that the insulin receptors in the brain cells are damaged because of the  senile plaques, etc  rendering the brain insulin resistant.  In other words this could be a neuroendocrine disorder and is being termed as Type-III diabetes. Diabetics, particularly those with Type-II, are more at risk, it is being postulated.   Researchers are working on this hypotheses and  growing evidence implicates unhealthy diet and lifestyle for the increasing number of patients.  Low glycemic diet, control over intake of nitrates and a healthy life style including exercise, are being suggested to counteract the disease.

PS: Times of India has reported on 18.1.2013 that a London based Indian researcher Dr. Mahaveer Golechha (who obtained his doctorate from All India Institute of Medical Sciences) has been selected by US based Alzheimer’s Drug Discovery Foundation for receiving the ‘Young Investigator Scholarship Award’ award for his work on ‘naringin’ which is a bioflavonoid found in grapes and other citrus fruits and has significant anti Alzheimer’s activity.  The award will be presented to him at the 7th Annual Drug Discovery for Neurodegeneration Conference to be held in San Francisco next month. 



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