08 March 2008
I used to work with patients suffering from Alzheimer's and other demetias when I was a clinical instructor in the Army. At the time, Aricept was one of the first drugs specifically labeled for treatment of Alzheimer's. Since then, it's not surprising that many advances have been made, so as I read this article was very surprised to see this:
Still, some controversy exists among experts as to what actually causes Alzheimer’s. Recent breakthrough research raises the question that Alzheimer’s could be a third form of diabetes. [emphasis mine]
I had never considered this but it makes a lot of sense. We already know that diabetes can have many chronic and potentially fatal complications. Cardiovascular disease, impotence, nerve damage, diabetic retinopathy... the list goes on and on. What most people don't realize about diabetes is that it's really about insulin, not sugar. I'm going to simplify this quite a bit, but it's pretty representative of what happens. Insulin is what breaks down sugar in the blood (glucose).
When your pancreas doesn't produce enough insulin, that's Type I (or Insulin Dependent Diabetes Mellitus -- IDDM). When your cells resist insulin and prevent it from working even though you have enough, that's Type 2 (or Non-Insulin Dependent Diabetes Mellitus -- NIDDM). It's really that simple... diabetics either don't make the insulin they need, or something in their cells keeps the insulin from working.
Alzheimer's is generally considered to be caused by the formation of amyloid plaques and tangles breaking down the brain's nerve cells. Now, how can problems with insulin be related to Alzheimer's? My guess (and it's only my guess, no research or anything to back it up. Just thoughts sparked by the linked article) is that if insulin is interfering with the transport or function of glucose (blood sugar) past the blood-brain barrier, it could possibly create the amyloid plaques and tangles assumed to cause Alzheimer's. This could be either through direct accumulation of waste sugars, damage from excess sugars in the vessels (kind of like creating scar tissue), or something else that I haven't considered.
The bottom line is that this will be very interesting research to watch in the future because curing one might end up meaning curing both. That would be fantastic.
Did you know that there is a growing interest among researchers that autism is related to thyroid function? Thyroid dysfunction is basically a hormone issue. Researchers who deal with autoimmune disorders are also looking more closely into the role of hormones.
This makes sense to me, although I'm not sure if it's a cause or an effect. I've had a lot of experience with my kid's autism and his related immune dysfunction, as well as a family history of autoimmune diseases. Surprisingly, there's a lot of practical overlap between things that don't seem related like Crohns Disease, autism, and rheumatoid arthritis. In addition, the other day at Patterico's, Kishnevi mentioned he thinks there is an overlap in his case between high-functioning autism and Crohns.
And to bring it back to your point, it's been my experience that people that have autoimmune, immune or even neurological diseases but that haven't been diagnosed as diabetic often exhibit hypoglycemic symptoms.
Thank you for posting on this.
Posted by: DRJ at 09 March 2008@15:02:47 (wE7Og)
Note to DRJ--I've been tested repeatedly for thyroid (because of the Crohn's) and come up clean every time. OTOH, I do, as you put it, exhibit hypoglycemic symptoms.
Posted by: kishnevi at 09 March 2008@20:07:46 (ntdZU)
DRJ, it certainly shows we have a lot more to learn. I have also noted that people with autoimmune diseases/disorders have concurrent conditions that on their face appear unrelated. Crohn's in particular gets a bad rap because the symptoms can be non-specific and variable, all while the sufferer appears pretty healthy. They often get accused of faking it, but more often behind their backs by jerks who don't think it will get back to their target. I've seen several Crohn's sufferers develop depression or substance issues related to the stress involved.
kishnevi, there's probably not much I can tell you about living with Alzheimer's than you already know. It's truly heartbreaking. One of the patients I worked with was a former doctor who ended up diagnosing himself. Unfortunately, his diagnosis was correct and by the time I took care of him he was very advanced. I'll add your mother in my prayers.
Posted by: Stashiu3 at 09 March 2008@20:44:26 (Q5ggV)
If it's okay with you, I'm going to email you some information I learned about Crohns and thyroid supplementation.
Posted by: DRJ at 09 March 2008@22:15:44 (wE7Og)
Posted by: DRJ at 09 March 2008@22:18:18 (wE7Og)
Posted by: sulla at 10 March 2008@22:45:23 (Y4/VY)
Posted by: Stashiu3 at 10 March 2008@23:02:45 (Q5ggV)
Just a little note of appreciation for this post, and an Alzheimer's care tip.
My dad had Alzheimer's and so I brought my parents to live with me. That way I could assist mom in his care. As you probably know, the real crisis occurs when an Alzheimer's patient can no longer feed themselves. We would spend hours feeding dad and as time went on he began to forget to swallow. I was beside myself because without being able to feed him, he would need to be in a professional facility. No one wanted that!
I was at the grocery loading up on Ensure when I noticed two things. First, there was a little girl, maybe three, sucking her thumb and in another aisle, an infant sitting in a cart happily nursing her bottle. It struck me that nursing was an instinctual behavior. No one teaches a baby to nurse; babies are taught to eat but not to nurse. I got an idea, maybe, just maybe, dad still possessed his instinct to nurse. A trip to the baby aisle found me buying two baby bottles and six or so nipples. Would it work?
After arriving home I cut a 1/4" hole in the first nipple but that made it too rough. I got out my hex wrench set, heated the 1/4" one on the stove and melted a hole in another nipple. That worked well.
Next, I took some turkey, a little gravy and some broth and whipped it in a blender to the consistency of heavy cream and put it in a bottle. Would it work?
I gave it to dad putting the nipple in his mouth. Wow. He grabbed hold of that bottle and held it until he had finished the whole thing. For the next year and a half dad used those bottles. Anything we ate at dinner was converted to a puree for dad.
What a relief, he was eating again and we didn't have to spend hours feeding him or having him placed on a feeding tube.
Just thought you might want to know.
Posted by: Jerrie.Atrick at 11 March 2008@17:37:02 (GZcfK)
We had several patients with feeding tubes for just that reason. They regress to the point where they forgot how to eat proper food. Your solution is ideal for home care, which is what most families prefer if they can manage it. I'll pass that on to some friends still working that field... I'm sure they'll give it a try with any family who's willing.
The consistency of the food is important. Too thick and it won't flow through properly. Too thin and they are likely to aspirate and risk very serious infection. It's much easier to avoid something going down the wrong "pipe" if it's a solid because swallowing is much more controlled (more muscle coordination, less suction).
Take Paddy for example... I'm sure he's had liquid go down wrong and started coughing far more times than food. Of course, when 95% of your intake is liquid... maybe he's not the best example!
Posted by: Stashiu3 at 11 March 2008@18:15:49 (Q5ggV)
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