Diabetes Self-Management Blog

We’re all getting older. And while there’s not too much we can do about it, for most of us, our hope is that we age with grace, dignity, and some semblance of normal cognitive and physical functioning. Others also hope to preserve their youthful appearance.

When diabetes comes into the picture, things can get murky. By this I mean that some evidence points to the link between Type 2 diabetes and a decrease in the ability to concentrate, problem solve, and provide thoughtful answers to questions. Other research indicates that people who have uncontrolled diabetes have almost twice the risk of cognitive dysfunction as people without diabetes. Why? It’s possible that constant high glucose levels impair small blood vessels in the brain, leading to ministrokes. Another possibility is that high glucose levels damage neurons (nerve cells) in the brain.

And not to spread doom and gloom, but evidence shows that people with both Type 1 and Type 2 diabetes have a 30% to 65% higher risk of developing Alzheimer disease compared with people who don’t have diabetes. Some researchers have coined a “new” type of diabetes, called “type 3 diabetes” that is marked by insulin deficiency in the brain. Folks at Rhode Island Hospital and Brown University discovered that insulin and certain kinds of protein are made in the brain; low levels of both can lead to degeneration of neurons, increasing the risk for Alzheimer disease.

So that brings us to this question: What, if anything, can be done to prevent a decline in cognitive function? Is there anything that we can do, take, or eat that will keep our brains and nervous system functioning at a high level as we get older? The answer? Maybe.

Dietary Supplements
It would be so easy to pop a pill or two and expect miraculous results. The reality, though, is that, at least when it comes to aging, there’s not a lot of evidence that any one particular supplement can help slow mental decline. But it’s early days yet, and hopefully scientists will discover the fountain of youth. Here are a few of the leading candidates that have been marketed as “brain supplements”:

  • Ginkgo biloba. Ginkgo biloba is an herb that has been used as a medicine for thousands of years. It’s one of the most commonly used supplements for brain health; in fact, Americans spent more than $100 million dollars on ginkgo in 2007. Why? While ginkgo is used for a number of different reasons, it’s often touted as helping to enhance memory and treat Alzheimer and dementia. Some early studies indicated that this herb might be beneficial for these conditions, but in a new study, published in The Journal of the American Medical Association, ginkgo failed to live up to its promise of slowing cognitive decline (the same authors of this study published another study last year that ginkgo also doesn’t help prevent Alzheimer and dementia). Ginkgo may possibly help with other conditions such as asthma, tinnitus (ringing in the ears), and fatigue, but it likely isn’t going to help boost brain function. Is taking ginkgo harmful in any way? Ginkgo can increase the risk of bleeding, and also cause headaches, nausea, dizziness, and skin reactions. There’s likely no reason to start taking ginkgo at this point. However, a typical dose is 120–240 milligrams per day divided into two to three doses.
  • Beta-carotene. Beta-carotene is part of a family of carotenoids — natural, fat-soluble pigments that give many fruits and vegetables their color. Beta-carotene is a provitamin (a substance that is converted into a vitamin in the body) because it gets converted to vitamin A. Carotenoids are considered to be antioxidants. Beta-carotene has been linked with cognitive functioning in the Physicans’ Healthy Study, a study designed to evaluate the benefits and risks of aspirin and beta carotene in preventing cardiovascular disease and cancer.

    Cognitive testing was added to the Physicians Health Study II, a second trial designed to evaluate various supplements for their ability to prevent cardiovascular disease, cancer, age-related eye disease, and cognitive decline. In this study, 4,052 men were given either 50 milligrams of beta-carotene or low-dose aspirin every other day from 1982 to 1995. An additional 1,904 men were also given either 50 milligrams of beta-carotene or low-dose aspirin every other day from 1998 to 2001. The men who had been taking beta-carotene long-term (for about 18 years) had a better memory than the placebo (inactive treatment) group. The researchers concluded that taking beta-carotene for many years improves thinking skills and memory. One of the study authors noted that the benefits seen with beta-carotene were greater than what was observed in a study with donepezil (Aricept), a drug used to treat Alzheimer.

    So should you start popping beta-carotene supplements? It’s hard to say. Beta-carotene supplements may increase the risk of lung cancer, prostate cancer, cerebral hemorrhage, and overall mortality in people who smoke or who have been exposed to high levels of asbestos. Beta-carotene from food sources (which include sweet potatoes, winter squash, carrots, spinach, kale, broccoli, and cantaloupe) are safe, although to get the equivalent of 50 milligrams of beta carotene, be prepared to eat about 4 cups of spinach every day!

More next week!

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Boosting Brain Health: Do Supplements Really Help? (Part 1)
Boosting Brain Health: Do Supplements Really Help? (Part 2)
Boosting Brain Health: Do Supplements Really Help? (Part 3)


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