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)


Comments
  1. Its easy to overdose with beta-caroteen supplements too. I have and was told by my doctor that the high concentration of vitamin A is the reason why Eskimos were always unable to eat Polar Bear Liver.

    Posted by Harry......................... |
  2. Thanks Harry. You’re right — one can take too high a dose of beta-carotene in supplement form, which may slighty increase the risk for heart disease and, in those who smoke, lung cancer. However, just to clarify: Beta-carotene is a much safer form of vitamin A. Polar bear liver contains extremely high doses of vitamin A, not beta-carotene, which can be fatal for humans.

    Posted by acampbell |
  3. An otherwise helpful article posted by acampbell Jan 14 2010 at 4:08 pm contains the statement “Polar bear liver contains extremely high doses of vitamin A, not beta-carotene, which can be fatal for humans.”.
    Is the author stating that vitamin A can be fatal for humans — or– carotene can be fatal for humans. Appreciate clarification.

    Posted by Bill |
  4. so if I began taking beta carotene, what is a safe dose for a woman with diabetes type2?

    Posted by gigi |
  5. Hi gigi,

    Six to 15 milligrams of beta carotene is a fairly standard dose.

    Posted by acampbell |
  6. Hi Bill,

    Too much vitamin A can be fatal. However, this is a very rare occurence, since most people don’t eat polar bear liver!

    Posted by acampbell |
  7. Amy, having taken nutritional supplements for many years, I’m a big believer in supplements and have found Healthy Humans as my current supplier. They are following an entirely new health care paradigm. Please contact me directly as I’d like to discuss this in more detail with you.

    Posted by Will Ryan |
  8. Thanks for the information and the peace of mind…
    I’ve been taking these vitamin A supplements for a while but was concerned when I heard you could overdose so was pleased to read your article and find it was still a sensible decision because I couldn’t eat that much spinach!

    Posted by Steve |
  9. You’re welcome, Steve. But I’m hoping you’re taking beta carotene, not vitamin A!

    Posted by acampbell |
  10. It’s not often you actually see an author replying to comments. I don’t know how relevant but I don’t take vitamin A supplements but do drink 2-3 bottles of carrot juice (Nake Juice) per week, which contains 400% of beta carotene.

    In fact, I really don’t take many supplements other than Vitamin B/Biotin for hair health (yeah.. I’m “maintaining”) and Vavalert brain supplement for improved focus and short/long term memory. i tried other products that contained very little more than synthetic (not food based) vitamins and was rather unimpressive. The differentiator for me with vavalert was the main ingredients of cocoa and green tea, which I researched and found studies that showed their synergy.

    Look forward to any suggestions/thoughts you have.

    P.S. Everything in moderation!

    thanks!

    Posted by Rami |
  11. I’d rather enhance my odds with positive bet on supplements. Dark red wine, Fish Oil, and others.
    Unless they hurt, I rather fault on safe side by taking.

    I got hemorages off my retina’s and healed up by gettin A1c down and Lutein, Vitamin C, Vitamin E and others. Did supplements help - who knows; my body and eyes did better.

    Posted by jim snell |
  12. Hi Rami,

    Vavalert is new to me. It contains theobromine, which is a chemical that is similar to caffeine. Theobromine is a stimulant, so it can cause rapid heart beat and can lower blood pressure. However, it appears to be relatively safe. Beyond that, though, I’m really not familiar with this supplement, so, as with kind of supplement, take it with some caution and stop taking it if you have any side effects.

    Posted by acampbell |
  13. Thanks for the great info, Amy.

    In reference to vavalert, i’ve been taking it along with my wife now since mid 2010 and it has had a profound impact on us both, in different ways… My chiropractor suggested it to me.

    I’m a cyclist and she is a marathon runner, we have 2 very active kids (thankfully they don’t need meds or supplements yet!) and so with that and owning our own businesses, lots of steady and unjittery mental energy and physical endurance is needed. We found that is exactly what vavalert offers. The claim the company makes is 6 hours of effectiveness but I’ve had days where I’ll really feel that extra kick for 9 or 10 hours. If I’m really tired and unrested, it won’t compensate for that but I don’t believe that’s what the product is supposed to accomplish.

    Lastly, I honestly don’t believe our experiences are placebo but who really knows! :)

    I still would love your feedback about any other products you might recommend. I know supplements affect us all differently.

    If I’m not mistaken, I believe the ingredients (cocoa & green tea extracts) of the product have been shown to help diabetics as well.

    Cheers from Newburyport, MA!

    Posted by Richard Madison |
  14. Hi Richard,

    I think the use of supplements needs to considered on an individual basis, for the most part. However, a few exceptions include vitamin D (because it’s hard to get enough from dietary sources), calcium (mostly for women), and omega-3 fatty acids. You mentioned cocoa and tea, and they contain polyphenols that may promote heart health, among other things. Other supplements, such as alpha-lipoic acid or evening primrose oil may help someone who has diabetic neuropathy, but these aren’t supplements that everyone needs to take or should take. You’ll see, in one of my other postings, that many people take cinnamon for blood glucose control (these are mostly people with Type 2 diabetes, though). Cinnamon hasn’t been shown to be so effective for people with Type 1 diabetes. So, my roundabout answer is: It depends on your health goals and what you’re aiming to do. You also need to consider your diet and the amount of certain nutrients that you get from food sources. I say this a lot, but it really can help to sit down with a dietitian to discuss issues such as this.

    By the way, Newburyport is a beautiful town!

    Posted by acampbell |
  15. If you can control diabetes 2 by diet, excercise,and medication. Can you undo the damage that may have been done to brain function. I was diagnosed with diabetes 2 years ago, my memory has steadily got worse. I have been blaming it on menopause, but I feel there is more to it. When my sugar is high I feel confuised and unable to process my thoughts. I also forget my co workers name and find myself stalling until I can remember a name or place. I started learning a new language because I felt this would aid brain function, it has just been very hard. My personality is changing from an outgoing person to a very quiet one, because it is embrassing when I can not remember the end of a story or a train of thought.
    Hope you can give some suggestions.

    Posted by Joy |
  16. Hi Joy,

    Unfortunately, I don’t really have an answer to your question. My advice is to talk to your physician about your symptoms and if they can be treated. He or she may refer you to a specialist. Also, do the best you can to control both your blood glucose and your blood pressure to lessen the chances of your symptoms worsening.

    Posted by acampbell |
  17. Joy Sorry for being late but just read your post. I’ll take a chance you’ll return and try to help. You need to control your blood sugar with diet and without any insulin or pancreatic stimulants. The reason you became Type II diabetic is because your triglycerides and sugars forced your pancreas to produce more insulin which made your body tissues and your brain “insulin resistant”. That is because insulin is a powerful hormone that the brain finds irritating when levels get too high. What happens then is the the “insulysin”…an enzyme that breaks insulin down, gets completely depleted by the excess levels of insulin so there is no insulysin left to do its other very important job which is to dissolve beta-amyloid plaques that develop in the brain in the presence of too much insulin and sugar. There is no “controlling” type II diabetes, there is just getting rid of it through diet, exercise and weight loss or suffer the long term ravages of an unhealthy condition with a bad outcome. If you get your weight down to normal levels and are vigilant about your diet, eliminating all refined sugars and eating sparingly 5-6 times a day from fresh, natural sources, your blood sugar will fall to normal levels and you will have beaten Type II. Controlling your blood sugar with medication is not beating the disease…it is accepting the disease as inevitable which it is not. You will need to make a complete change of diet and lifestyle and get to a normal weight to eliminate the disease’s negative effects. My father was Type II at age 40 and he beat it by losing 100 lbs, reverting to a 5 meal a day plan, eliminating all sugars, and eating salad several times a day. He did not exercise but he also refused insulin and all pancreatic stimulants. He lived to be 82 and died peacefully in his sleep while watching TV. Had he exercised, he probably would have lived longer. So in this area, you have already done yourself a big favor.
    If you keep taken “medication” for Type II, then you remain a patient. You should take a course of action that results in no longer being a patient with diabetes. Otherwise, your brain function is not likely to improve. It is entirely up to you and only you can do this. Your doctor cannot restore your health but can slow its progression and some of its discomforts. If you do not choose correctly, it will eventually cost you your life. I have known many Type II diabetics and most of them are no longer with us. I am 64 years old and I’ve seen enough to know that as long as you “treat” your Type II, you still have the disease and it will eventually kill you just as it did many of my friends and relatives who were unable to make the changes to a healthy diet and lifestyle.
    For dietary supplements that help with cognition, memory, brain health and Type II, here is a list:
    Ginko Biloba, all the B vitamins and particularly B6, B9, and B12 (B9 is folic acid), up to 3.0 grams (3,000 mg) of Omega 3 per day (some from flaxseed source as well as from fish source) acetyl-l carnitine, alpha lipoic acid, lecithin, phosphatidyl choline, phosphatidyl serine, CoQ10, Sam-e and Cinnamon plus chromium. You should be taking a multivitamin with minerals appropriate for your age and sex and make sure it has magnesium, selenium, and manganese sulfate.
    Here is some good advice from a diabetic man who outlived three of his doctors who were specialists in diabetes: “Remember that doctors only have a license to practice medicine. Don’t let them practice on you!” Good luck and I wish you the veru best. I suggest you learn as much as you can about your problem on the internet and take full responsibility for your health and not expect your doctor(s) to do for you what only you can do. There are no short cuts and there is no easy way. Its making the right choices and its a life-long 365 day a year plan that will cure you.

    Posted by Peter B Rutkiewicz |
  18. One of the curious studies I saw in a science journal at Doctor’s office recently was whether antioxidants used to stop free radicals really stopped aging and extended life.

    The argument was done on studies on worms ( not exactly humans) and they could see no life extension from agressive use of anti-oxidants and stopping free radicals.

    That said, I still take all my supplements for that issue ( dark red wine, vitamin C etc).

    Science is getting like the legal business. A good lawyer who assisted me once stated that if he couldn’t argue each side of a question successfully he couldn’t consider himself an accomplished attorney.

    Posted by jim snell |
  19. Hi,
    I’ve been reading all the posts here as well in a search for supplements that might help my issues with cognitiveness and short term memory loss.

    I do not suffer from any forms of diabetes, but many of the other symptoms are similar such as not being able to remember the name of a street in my neighborhood that I’ve been driving on for almost ten years. Or the name or face of a customer I see on a regular basis, I’ve always been terrible with names to begin with. I can work for a customer in the morning and if they walked in to the shop that afternoon I would not recognize it was them.

    I have also experience cognitive issues like that “just woke up” or “groggy” feeling for years, I have never been able to shake it, but I suspect it is related to my gastric issues (GERD) as the incidents have decreased somewhat since I started taking Omeprazole. I still get tired or groggy, and can lose focus when trying to concentrate in situations like extensive conversations with customers.

    Issues like remembering names and such are relatively minor now, but I fear they may get worse as I get older. Up to now I have been writing it off as “getting older” I am now 46. However I cannot help but wonder if there is an underlying problem that I do not yet know of and this is why I started researching if there is perhaps something important missing from my diet.

    Although I work a fairly physical job, I am weak in the areas of cardio and legs, particularly the knees. I can run on a treadmill but not more than 5 mins. I have a mild form of COPD from smoking for 28 years but I quit and have been smoke free for over 5 years now.

    I live a realitively healthy lifestyle, good home cooked meals most nights, not a lot of fast food or high sugar drinks, but I rarely eat fish or anything with Omega 3 in it. I’m wondering if that is the cause.

    I see Ginko biloba pop up a lot when it comes to helping brain flow and memory but I have also read some bad negative things about it as well.

    From what I have read the common supplements I should be looking at are Omega 3 fish oils, possibly Ginko, vitamin B’s, and Beta Carotene.

    Sorry for the long winded letter but there is lots of info for you that my doctor would never give me time to explain. Perhaps some of my descriptions are a common denominator for other readers here.

    Look forward to your response.

    Posted by Richard J |

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