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Monday, March 26, 2007

You Can Stem the Alzheimer’s Rot in Diabetes

I do not know about you, but I fear old age more than death! It is not just a matter of diabetes. Even my loved ones with normal glucose metabolism should have someone to provide total and loving care, should they live to lose some of their mental faculties.

Everyone needs to know about dementia, because we may be called upon to look after a parent even if we do not suffer from any type of this dreaded condition ourselves. Alzheimer’s is the best known, but not the only form of dementia.

Medical scientists are not yet certain about the causes of various kinds of dementia including Alzheimer’s. There are a few studies which indicate that there may be links with diabetes, but we are not sure of the inter-connections as yet. It is known however, that poorly managed diabetes will damage blood vessels that supply nutrients and oxygen to deep recesses of the brain. It is therefore reasonable to assume that excellent diabetes management will help keep brains in good working condition as we age. Unfortunately, keeping blood glucose under control is not a guarantee against dementia, but it could help to delay onset and progression.

Some amount of loss of mental faculties is normal with ageing. It is therefore nearly impossible to distinguish various kinds of dementia from normal ageing. Experienced clinicians can make informed judgments, especially with the aid of modern brain scans, but only an autopsy can support a confirmed diagnosis.

There is no room for despondency because there is much we can do to manage dementia. Here is an outline of 3 points which you should discuss with your Primary Care Physician, or mail me for individual counsel:

1. Keep blood glucose within normal levels at all times. Monitor your glycosylated hemoglobin every 6 months to make sure that you have your diet/exercise/medication blend just right.

2. Exercise your brain. Nerve tissue is like muscle in the sense that it wastes away if you do not use it. Work on your logic. Write on subjects you know well-even if no one reads it! Learn new subjects. Throw away calculators and do sums in your head. Memorize songs, psalms, or whatever you like.

3. Ask a Psychiatrist to monitor changes in your GAF (Global Assessment of Functioning) every year. This will act as an early warning system, and help you stave off or slow down any type of dementia.

Since there are no firm assurances available in this area, you should be proactive and tell people such as your doctor, close family, and best friends, how you would like to be treated should you develop dementia. Hopefully, such decisions will never have to be implemented, but it is comforting to decide on how to deal with such extreme tragedies on your own, rather than have others think on your behalf

Dementia incidence good rise dramatically as life expectancy grows. It is now possible to live much longer than ever before, even with diabetes. It will pay to be forward-looking, and to prepare for comfortable and dignified life in old age.


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