Numerous studies have shown a connection between diabetes and dementia. The connection is significant. Your Brain Matters (n.d.) reports that diabetes increases the risk of any type of dementia by 47 percent and of Alzheimer’s disease specifically by 39 percent. Diabetes increases the risk of vascular dementia by a whopping 138 percent. Another report asserts that diabetes increases dementia risk in general by 100 percent (Colino, 2017). While other groups and studies have reported slightly different numbers, the pattern is evident: diabetes can contribute to dementia in general and Alzheimer’s in particular.

That diabetes, and even prediabetes, are risk factors for cognitive decline, impairment and dementia has been established. Also, known is that diabetes and its problems with blood sugar, insulin, blood vessel damage, and nerve damage contribute to the development of brain diseases. What isn’t fully understood is exactly how diabetes can change the brain.

Researchers continue to study the connection between dementia and diabetes, so our knowledge will continue to grow. Here’s a look at what is known so far, because when you know about the connection, you can take measures to prevent it in yourself or a loved one.

Diabetes and Dementia: What is Dementia, and is there a Type 3 Diabetes?

Dementia is a general term for a group of symptoms and experiences. Dementia in general involves:

• Memory loss
• Difficulty with problem-solving
• Confusion/thinking problems
• Problems with language usage

Dementia can range from mild to severe and involve minor disruptions to daily life to serious disability. Forms of dementia include mild cognitive impairment, vascular dementia (brain damage due to reduced blood flow to the brain, possibly caused by blood vessel damage from high blood sugar), other forms of dementia, and Alzheimer’s disease.

Alzheimer’s disease is a brain disease that worsens over time ("Alzheimer's Disease: Prognosis and Complications"). It severely impedes memory, learning, reasoning, communication, and the ability to complete ordinary daily tasks. Alzheimer’s can even cause changes in personality or behavior and often leads to increased anxiety, agitation, paranoia, and delusions.

Type 2 diabetes is a risk factor for dementia, including Alzheimer’s. Of course, not everyone with diabetes will develop dementia, and not every person with Alzheimer’s has type 2 diabetes. The connection between these diseases, however, is significant enough that Alzheimer’s is sometimes called Type 3 diabetes or even brain diabetes. Type 3 diabetes isn’t an actual type of diabetes. It refers to the contribution diabetes makes to Alzheimer’s disease.

What is the Link Between Diabetes and Dementia?

Diabetes is a disease in which the glucose (sugar) created during digestion can’t get out of the bloodstream and into the cells as it should. Glucose is a source of energy for the body and is the brain’s primary energy source. In diabetes, blood sugar can be too high at times and too low at others. This fluctuation between unhealthy extremes can lead to brain damage.

Many aspects of diabetes can damage the brain enough to lead to dementia:

• Hyperglycemia (high blood sugar)
• Hypoglycemia (low blood sugar)
• Improper use of glucose
• Blood vessel damage that reduces blood flow, starving brain of energy, oxygen, and nutrients
• Excess insulin that leads to changes in brain chemistry
• Chronic inflammation due to hyperglycemia

Additionally, studies have shown that type 2 diabetes might lead to the build-up of toxic proteins in the brain. Diabetes seems to contribute to dementia in part by impairing the brain’s ability to remove waste products. Diabetes also interferes in the creation of new connections between brain cells.  

It’s clear that insulin, glucose, blood vessel damage, and inflammation in diabetes contributes to dementia. However, brain damage isn’t guaranteed. If you live with diabetes or prediabetes, you’re not doomed to dementia.

Lower Your Risk of Both Dementia and Diabetes

You don’t have to passively wait and hope that diabetes doesn’t cause dementia. There are many factors in your control that you can take charge of. The actions that reduce the risk of diabetes and improve the effects of the disease are the same actions that lower your risk of dementia and Alzheimer’s.

• Be intentional about what you eat. Avoid processed, sugary foods and get plenty of whole grains, fruits, vegetables, and protein
• Increase your physical activity. Exercise most days of the week, and do something you enjoy.
• Maintain a healthy weight
• Don’t smoke
• Limit alcohol
• Keep regular appointments with your doctor and diabetes care team
• Take prescribed medications

You don’t have to make major changes all at once in order to improve your health. Identify small steps to begin, do them regularly, and gradually add more. These lifestyle changes can improve diabetes and help prevent dementia, including Alzheimer’s disease.

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Are you at risk of developing diabetes? The average American has a 1 in 100 chance (1 percent) of developing type 1 diabetes by age 70 years. The chances of getting type 2 diabetes are at 1 in 9 (11 percent). That’s why understanding diabetes risk factors is an important part of avoiding this serious illness.

Diabetes defined is a group of illnesses in which the body either doesn’t produce enough insulin or doesn’t use insulin efficiently. In either case, glucose (sugar that is the product of the digestion of carbohydrates) stays in the bloodstream rather than being led by insulin into the body’s cells. The result is hyperglycemia, or high blood sugar, and there are numerous health dangers accompanying it. Certain diabetes risk factors indicate that someone’s chances of diabetes are higher than average.  

Diabetes is categorized by type, and diabetes risk factors differ accordingly. The main types of diabetes are type 1, type 2, prediabetes, and gestational diabetes (sometimes called GDM for gestational diabetes mellitus). Each one is unique and comes with its own set of risk factors, although there is overlap between some of the types.

Here’s a look at diabetes risk factors by type.

Risk Factors of Diabetes Type 1

In type 1 diabetes, the body doesn’t make insulin or makes such a small amount that there’s not enough to move glucose from the bloodstream into the cells of the body. Type 1 usually begins in childhood or early adulthood; however, it can develop at any age ("What Are the Symptoms of Diabetes in a Child?").

Unfortunately, risk factors of diabetes type 1 are poorly understood. Medical professionals and health researchers have identified a few factors that are involved in the onset of type 1 diabetes:

• Genetic components
• Environmental elements
• Autoimmune aspects

While researchers are working to pinpoint risk factors of type 1 diabetes, it’s currently impossible to predict who will develop this disease and what puts people at increased risk.

Type 2 Diabetes Risk Factors and Risk Factors for Prediabetes

Unlike type 1, the diabetes risk factors type 2 are well understood by the medical community. Because one-third of adults in the United States is in jeopardy of this illness, and because type 2 is preventable, knowing the risk factors is essential.

Are you or a loved one at risk? Check out this list of type 2 diabetes risk factors to determine how many you have:

• Overweight or obesity
• Body mass index (BMI) higher than the normal range
• Sedentary lifestyle
• Poor nutrition and other eating habits (overeating, eating while watching television or on the run)
• High blood pressure
• Family history of diabetes (parents, siblings with diabetes)
• Age (while even children can develop type 2, the risk increases over the age of 40)
• Ethnicity (people of African, Latino, Asian, Pacific Island, or Native descent are at increased risk of type 2 diabetes)
• Prior gestational diabetes

There is also a condition known as prediabetes. Prediabetes means that blood sugar levels are higher than normal but not yet high enough to be diagnosed as type 2 diabetes. The prediabetes risk factors are the same as those for type 2. Having prediabetes increases the risk of developing type 2 diabetes.

Gestational Diabetes Risk Factors

Gestational diabetes is diabetes that develops during pregnancy and disappears within approximately six weeks after delivery. Gestational diabetes risk factors are similar to those for type 2 and prediabetes and include:

• Overweight or obesity
• Smoking
• High blood glucose
• Unhealthy cholesterol levels
• High blood pressure
• Sedentary lifestyle
• Poor nutrition and consumption of unhealthy food and drinks
• Over age 25
• Family history
• Ethnicity (the same ethnic groups at higher risk for type 2 are also at increased risk for gestational diabetes)

Knowing if you have the risk factors for diabetes can help you know if you or a loved one could be in danger of developing diabetes ("Do I Have Diabetes? Here's How to Tell "). This allows you to become less susceptible to the disease and even prevent it by avoiding the risk factors for diabetes.

If you think you may be at risk for diabetes, talk to your doctor and work with him or her to develop a health plan. Make lifestyle changes that eliminate the risk factors and replace them with a life of wellness.

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ADHD and diabetes are two very different illnesses that can look surprisingly similar at times. When you or your child lives with both attention deficit hyperactivity disorder and type 1 diabetes, you might notice that one condition influences the other and that there are even some shared symptoms between diabetes and ADHD. Identifying the similarities between these two difficult conditions can help you recognize the symptoms you’re dealing with so you can take steps to feel better.

ADHD and Diabetes: Different Illnesses, Shared Symptoms

Diabetes is a disease of metabolism in which the body can’t use the glucose (sugar) it produces during digestion. When you eat carbohydrates, they’re digested into glucose and enter the bloodstream where they’re transported to all of the body’s cells to be used as energy. Glucose can’t enter cells by itself but instead needs a key to get in. That key is the hormone insulin.

In diabetes, there is a problem with insulin that prevents glucose from entering your body’s cells. Type 1 diabetes is an autoimmune disorder: the body’s immune system attacks the pancreas, the organ that makes insulin, rendering the body incapable of making insulin. In type 2 diabetes, the body produces insulin, but it either makes too little or the body just doesn’t use it efficiently. In both forms of the disease, the body can’t use or control blood sugar on its own; therefore, you must take on the stressful and difficult job of controlling your blood sugar for your whole system.

ADHD, in contrast, is a brain-based disorder that impairs such functions as focus, attention, memory, organization, attention to detail, and behavior. Like diabetes, hormones are involved. Rather than problems with insulin levels, though, ADHD involves hormones known as neurotransmitters, including dopamine and norepinephrine.

Despite the differences, diabetes and ADHD symptoms can overlap. Symptoms shared by these illnesses include experiences like:

• Irritability
• Anger (see "Diabetic Rage: Can Diabetes Cause Aggressive Behavior?" and "How to Handle ADHD and Anger in Adults")
• Mood swings (see "Does Diabetes Cause Mood Swings?")
• Feeling frustrated and overwhelmed
• Guilt and self-blame for being unable to function the way you “should” be able to
• Depression (see "What Are the Effects of Diabetes on Mood Disorders?" and "Diabetes and Depression: Two Difficult Conditions to Manage")

These experiences are a result of what is happening in the body. Blood sugar levels that remain too high (hyperglycemia), too low (hypoglycemia) or that fluctuate too rapidly can cause emotional effects. Similarly, changing neurotransmitter activity affects levels of dopamine and norepinephrine as well as what the brain does or does not do with these hormones.

Knowing that diabetes and ADHD can look similar can help you improve your treatment of both conditions. Use the similarities to your advantages to treat them at their source.

Similarities in Treating ADHD and Diabetes

Living with either ADHD or diabetes can be highly frustrating because each one interferes in daily life, and each requires constant management to keep in control. Living with both of these together magnifies the difficulties.

You can use similarities between them to your advantage and manage your illnesses together.

Work with your doctor to develop a treatment plan for both diabetes and ADHD. Both can be treated using these approaches:

• Medication
• Nutrition/diet
• Regular exercise
• Education

In implementing your treatment plan, keep in mind that routine is critical. ADHD makes it difficult to remember what you need to do or to follow through with your plan even when you remember what it is. Developing a routine, and writing it down in a visible place, will help you tend to your treatment needs.

Working with a therapist who understands the unique needs of diabetes and ADHD can drastically improve your thoughts, feelings, behaviors, and overall mental health and wellbeing. Cognitive-behavior therapy (CBT) has been shown to be effective in replacing feelings of anger and frustration with acceptance and helps people deal with the challenges of living with ADHD and diabetes in order to thrive.

Diabetes and ADHD are drastically different yet share similarities. Perhaps the most important similarities for your health and wellbeing are that they do require daily management, but you can learn to treat and manage both in a way that works for you and moves you forward. Your life doesn’t have to be severely limited by ADHD and diabetes.

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Proper management of schizophrenia and diabetes is imperative for physical and mental health. Both illnesses require structured treatment plans and continuous monitoring and attention. Without sufficient care and management, quality of life, physical health, and mental health plummet. Worse, the risk of death increases. Someone living with schizophrenia faces a shorter lifespan than those without it; tragically, schizophrenia shortens lives by up to 30 years. Having diabetes further increases the risk of early death. Treatment and management are essential but quite difficult. Multiple obstacles interfere with diabetes and schizophrenia management ("The Strong Link Between Schizophrenia and Diabetes").

The Difficulties of Schizophrenia and Diabetes Management

Treating these two illnesses can feel like an insurmountable challenge. Treating just one can be hard. When someone is dealing with both schizophrenia and diabetes, they face numerous obstacles.

One treatment problem involves medication that must be taken in order to treat schizophrenia’s hallucinations and delusions. In many cases, antipsychotic medication needs to be strong in order to reduce symptoms. As effective as antipsychotics are in reducing the symptoms of schizophrenia, they make diabetes worse.

Antipsychotics come with side-effects. Among the many unwanted effects of antipsychotic medication are significant weight gain, high cholesterol, and increased triglycerides (fats in the bloodstream). These can cause type 2 diabetes to develop quickly (see "Do Antipsychotic Medications Cause Diabetes?"). If diabetes is already present when antipsychotic treatment begins, diabetes complications worsen. Blood sugar becomes more difficult to control, and complications of hypo- and hyperglycemia become dangerous. Poorly managed diabetes leads to a host of health problems.

Sometimes, switching to a different antipsychotic medication or lowering the dose can help reduce the negative impact on diabetes ("Are There Any Safe Antipsychotics in Diabetes Treatment?"). That’s not always an option, though, because by changing or adjusting antipsychotics, there’s a risk of making the psychotic symptoms of schizophrenia worse. Treating schizophrenia with antipsychotics can worsen diabetes, but helping diabetes by reducing medication can intensify schizophrenia. Finding the right medication and dosage is a delicate balancing act.

Beyond medication, the nature of schizophrenia makes diabetes management tough. Schizophrenia is associated with unhealthy lifestyle factors, all of which contribute to or exacerbate diabetes. Some factors include:

• Sedentary lifestyle
• Lack of proper nutrition
• Cigarette smoking
• Obesity
• Non-adherence to treatment
• Impaired insight
• Poor insight/understanding of the impact of these illnesses
• Limited access to medical care

Schizophrenia even interferes in self-care. Diabetes requires self-care, but schizophrenia makes that hard. Schizophrenia can cause problems in executive functioning, working memory, and motivation. When hallucinations and delusions are part of the picture, the ability to monitor and treat blood sugar levels is drastically reduced. Blood sugar goes uncontrolled, and complications arise.

Facing these treatment obstacles can be disheartening. As each condition worsens, both become even more difficult to keep under control. There are some solutions that can make schizophrenia and diabetes management a bit better.

Solutions to Schizophrenia and Diabetes Management

As with many things in life, early detection can improve outcomes. Because diabetes is so common in schizophrenia, it’s important that people be screened immediately upon receiving a diagnosis of schizophrenia.

Doctors may take baseline readings of height, weight, body mass index (BMI), blood pressure, fasting plasma glucose, and lipid levels. Then, these should be remeasured and compared to initial readings at every medical visit. This allows doctors to catch things like increases in weight and blood sugar levels early and treat them before they spiral out of control.

Consistent, thorough care is important for people with schizophrenia and diabetes. In addition to frequent medical visits, other steps must be taken for proper care. Among the management solutions:

• Lifestyle management to watch weight, exercise, and diet
• Quitting smoking
• Increasing nutritious eating and decreasing processed foods, soda, etc.
• Psychoeducation to increase understanding and motivation to follow through with treatment
• Self-care

Living with and treating both diabetes and schizophrenia is overwhelming. People living with these conditions need a support system. Getting to regular doctor visits, complying with medication, monitoring blood sugar, and engaging in other management plans can be nearly impossible without support. With help, someone’s chances of treatment compliance and success increase.  

One more key point to remember for improved treatment is that these two different conditions are so interconnected that the best thing to do is often treating them as one. A holistic treatment approach that attends to physical and mental health is perhaps the best road to the management of diabetes and schizophrenia.

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Diabetes and depression are difficult. Each one is challenging by itself, and when they occur together, managing them might seem impossible. It’s not unusual for diabetes and depression to develop together and make each other worse.

If you live with diabetes, it’s important to watch closely for the development of depression. When someone has both illnesses, their level of impairment increases, and daily tasks and overall functioning becomes more of a struggle. Even more sobering is that the mortality rate increases when diabetes and depression occur together.  

This doesn’t mean, however, that the illnesses are a death sentence. Use the information here to start a plan to manage your health.  

Diabetes and Depression: A Two-Way Street

Having either illness increases the chances that the other will develop. The conditions aggravate each other, too. When depression worsens, so does diabetes; likewise, when diabetes worsens, so does depression.

A reason for the connection is that they have shared risk factors ("What Are the Diabetes Risk Factors?"). Researchers have found that both diabetes and depression have biological and behavioral components underlying their development. The illnesses are:

• Strongly influenced by lifestyle
• Associated with chronic inflammation in the body
• Exacerbated by sleep problems
• Influenced by the hypothalamic-pituitary-adrenal (HPA) axis functioning in the brain
• Genetically influenced

Given their shared risk factors and causes, it makes sense that depression and diabetes occur together. Aside from this common ground, each illness contributes to the other.

Diabetes: So Difficult That It Can Cause Depression

Diabetes can sometimes lead to depression. Having diabetes can cause depression in two significant ways: life experience and biology.

Biologically, diabetes impacts the brain in ways that can contribute to depression. Insulin resistance is a part of type 2 diabetes in which the body doesn’t use its insulin correctly, causing a variety of health problems.  Hyperglycemia, or high blood pressure, is another aspect of both types of diabetes that causes damage throughout the body. Insulin resistance and hyperglycemia can negatively affect the brain. One such negative impact is the development of depression.

Depression can develop, too, from the experience of living with such a life-altering disease. Life with diabetes is constantly stressful and can affect thoughts, emotions, and behavior profoundly enough to lead to depression.

Managing diabetes and trying to live a “normal” life can feel overwhelming and sometimes make you want to give up trying to treat it. It can be energy-zapping and can induce strong emotions like guilt for having diabetes or despair over missing your old lifestyle.

Given the biological and experiential causes, it’s no wonder that diabetes can cause depression. The statistics are telling. Type 1 diabetes and depression have the strongest link: People with type 1 diabetes have a risk for depression that is three times higher than the non-diabetic population. The depression risk in type 2 diabetes is double that of the general population.

Yes, diabetes contributes to depression. Also, depression plays its own role in the worsening of diabetes.

Depression Makes Diabetes Harder to Control

Having depression is hard to deal with. Add diabetes on top of that, and managing these illnesses seems daunting. Some of the things people with depression experience are a loss of interest in life, feeling overwhelmed, crushing fatigue, appetite changes, and lack of motivation. Diabetes needs continual management and monitoring, but depression symptoms get in the way of diabetes control.

Depression can also cause unhealthy eating or overeating, both things dangerous to diabetes and blood sugar levels. Depression medications play a role in diabetes as well because many antidepressant medications make blood sugar difficult to control.

Depression can keep people from properly managing their diabetes. This worsens diabetes symptoms, which in turn worsens depression symptoms.

Despite problems, it is possible to manage diabetes and depression. Once improvements begin, they become easier and life feels so much better.

Managing Diabetes and Depression: Hard but Not Hopeless

Now that you know more about the connection between these illnesses, you can be proactive. Early intervention is helpful. Whether you’re able to stop the downward spiral of worsening diabetes or depression symptoms before they get out of hand or if you’re deeply into depression and diabetes difficulties, you can take control of the illnesses and your life.

• Make small lifestyle changes and gradually add to them over time. Diet, exercise, and sleep are just a few things that help both diabetes and depression.
• Discuss medication options with your doctor to find what works best for you.
• Consider working with a therapist to deal with depression and lifestyle changes.

Little changes go a long way toward wellbeing. Changing even one thing to start will make a positive difference.

One study demonstrated that people with diabetes who added more vegetables, fruits, whole grains, and other healthy foods to their diet had 32 percent lower chances of depression than those who didn’t make this healthy change (Rodriguez et al., 2015). You can create similar great results for yourself and keep going.

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Diabetes causes brain fog and memory loss. Both are frustrating and can drastically reduce someone’s ability to complete daily tasks. Brain fog isn’t an official diagnosis but instead is a blanket term that aptly describes how someone is experiencing the world. As its name implies, brain fog makes people feel as though they’re enshrouded in a fog so thick they don’t know how to find their way out. Diabetes is a cause of brain fog and the memory loss that often is a part of brain fog.

Diabetes causes serious health problems throughout the body. The brain isn’t exempt from damage, and symptoms of brain fog make the disease even more difficult to deal with. Brain fog can involve:

• Memory loss and forgetfulness
• Fuzzy thinking/slowed thoughts
• Brain fatigue
• Problems focusing, concentrating
• Difficulty following conversation
• Struggles in finding the right words in conversations
• Exhaustion
• Confusion

Specific mechanisms of diabetes cause brain fog and memory loss.

Diabetes Problems and Brain Fog Starts with Blood Sugar

Diabetes begins with insulin and blood sugar. When we eat, glucose (a sugar) is created during digestion. It enters the bloodstream where it’s joined by a hormone called insulin. Insulin helps glucose leave the bloodstream and enter the cells for energy. Glucose is the main source of energy for the brain

In diabetes, there is a problem with both glucose and insulin that leads to a host of problems. Glucose needs insulin to enter the cells, but in diabetes either the body can’t make insulin, doesn’t make enough, or can’t use its insulin correctly. As a result, glucose remains in the bloodstream and accumulates. High blood sugar (hyperglycemia) does extensive, system-wide damage. Low blood sugar (hypoglycemia), a result of diet and/or medication, also causes damage. These blood sugar problems impair functioning in the brain and can cause brain fog and memory loss.

Blood sugar fluctuations affect neurotransmitter levels. High blood sugar increases serotonin and GABA, causing fatigue. Low blood sugar causes the brain to make more cortisol, glucagon, and adrenalin in an attempt to counteract hypoglycemia. Stress increases, and concentrating and focusing become more difficult.  

The fluctuations between blood sugar extremes can leave you feeling tired yet wired, and your brain can have a hard time adjusting to fluctuations. In addition to the impact on neurotransmitters, fluctuating blood sugar leads to:

• Brain cell damage and degeneration
• Nerve damage
• Inflammation of the brain
• Injury to neurons due to insufficient glucose supply

When the brain is inflamed and impaired, functioning becomes difficult. Diabetes and brain fog disrupt life as do diabetes and memory loss.

Blood sugar creates another problem that contributes to brain fog and memory loss: blood vessel damage.

Blood Vessel Damage in Diabetes Leads to Brain Fog, Memory Loss

Blood sugar highs and lows create problems with blood circulation. Restricted circulation to the brain starves it of nutrients and oxygen. The brain can’t function at its peak when it lacks nourishment; therefore, symptoms of brain fog begin.

Circulation problems aren’t the only effect diabetes has on blood vessels. Hyperglycemia damages vessel walls over time, reducing their flexibility and responsiveness to the blood flow within them. In the brain, blood vessels need to flex to accommodate changing circulation. The brain adjusts the amount of blood it uses to support the functioning of various areas and structures. When blood vessels are rigid, they don’t move fluidly to supply nutrients and oxygen where they’re most needed. As a result, memory loss, reasoning, processing speed, and more are compromised ("Diabetes of the Brain: How Diabetes Affects the Brain").

Diabetes and brain fog make life difficult. Is there a fix?

Can Anything Help Diabetes, Brain Fog, and Memory Loss?

So far, there isn’t a cure for diabetes, nor is there a known way to end brain fog and memory loss that diabetes can cause. However, there are things you can do to improve your blood sugar and minimize the effects of brain fog.

Lifestyle changes are key to improving blood sugar control.

• Increase physical activity, exercising almost every day for at least 30 minutes
• Reduce processed foods, including sugar
• Increase healthy foods (vegetables, proteins, whole grains, healthy fats)
• Drink water to hydrate your brain
• Sleep seven- to eight hours per night

Sometimes, lifestyle changes don’t do quite enough to repair brain damage and reduce brain fog and memory loss. Researchers are working on developing a medication that will repair blood vessels.  Such medication is still in the future, however, so being vigilant about healthy lifestyle choices is essential. Diabetes and brain fog and diabetes and memory loss don’t have to interfere in the quality of your life.

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Numerous challenges arise in managing diabetes when living with OCD. Diabetes brings many difficulties to someone’s life. OCD also brings many difficulties. Having to live with and manage both can create problems for someone living with these illnesses ("Diabetes and Mental Health: How One Affects the Other "). An inability to properly manage diabetes can create serious health and quality-of-life issues.  

How OCD Makes Managing Diabetes Challenging

Diabetes requires constant monitoring. Blood sugar must be watched multiple times per day to ensure that it’s at the proper level—too much blood sugar (hyperglycemia) and too little blood sugar (hypoglycemia) both pose immediate and long-term health risks. This is anxiety-provoking and stressful for nearly everyone. For those with OCD, it can feel overwhelming and out-of-control ("Diabetes and OCD: Obsessing Over Your Blood Sugar Levels").

Some reasons why OCD makes it hard to manage diabetes include:

1. The thought processes and brain activity in OCD create the perpetual feeling that something is off. This causes extreme agitation, and the imagination goes wild as obsessive worries and what-ifs take over the thoughts of someone with OCD. What if my blood sugar drops too low and I go into a coma and can’t wake up? What if my blood sugar is too high but I don’t know it because the readings are off?  Worries about health disasters become obsessions that consume time and energy.
2. Managing diabetes is largely about managing numbers. Blood sugar levels must be measured so they are properly treated to stay in the right range. Food and nutrition, amount of exercise, amount of insulin needed at any given moment—these are a few things that must be monitored. In OCD, monitoring escalates into obsessing. The obsessions can lead to poor choices such as over-monitoring or taking too much insulin to overcompensate for a high blood sugar reading.
3. Often, for those with OCD, diabetes management consumes a great number of their thoughts and behaviors because it centers around the need for tight control. Having “good” blood sugar readings, for example, isn’t enough. Obsessive thoughts about the need for perfect readings drive people to compulsively check their blood sugar levels so often that it interferes in other aspects of their lives.
4. Diabetes management can become excessively burdensome with OCD. Recording readings like blood sugar levels and the amount of insulin taken is common in diabetes management. For someone with OCD, record keeping can consume a great deal of time and energy. Someone might check their blood sugar levels fifty times a day and record each reading in a special chart. They will likely chart other things, too, often anything related to the body and its functioning, to watch for problems to address. Life can become largely about the data and charts.
5. Having obsessions about controlling all aspects of diabetes and health is incredibly stressful. Trying to perfectly control diabetes can increase stress, which in turn negatively affects diabetes and causes blood sugar fluctuations. These spikes and drops cause more anxiety and obsessions. OCD and diabetes can negatively impact each other in a vicious circle.

Rising to the Challenge of Living with Diabetes and OCD

Diabetes and OCD can indeed influence each other and cause great difficulty. The fact that both are permanent illnesses without cures (at least not yet) increases frustration and hopelessness. How can someone learn to properly manage both diabetes and OCD when they are having difficulty managing just one of them alone? It can feel very discouraging, but there is hope. You can learn to manage OCD and diabetes.

An important first step is to develop your perspective on the illnesses and your health and wellbeing. If you’re obsessing over diabetes management, believing you need complete control over your blood sugar 100 percent of the time, ask yourself why. Why do you want such control? What is your end game?

Many people state that they value their health, that they want to be healthy. Why? They want to enjoy life. If this is you, the next question to ask yourself is important: Are you living the quality, healthy life you want by obsessing and compulsively checking blood sugar and other aspects of diabetes?

If your answer to that is a resounding no, and you want to shift to health and happiness, you now have a new perspective to lead you into treatment.

Working with your doctor and a therapist who understands diabetes can be very beneficial in changing your obsessive thoughts and improving diabetes management. Cognitive behavior therapy is often helpful in managing OCD. You’ll learn to notice obsessions and compulsions, understand that you don’t have to believe them or act on them, and replace them with thoughts that lead to better diabetes management and better life management.

If you have OCD and diabetes, you’re not doomed to a life of struggle. You can learn to manage both and increase the quality of your life.

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Type 2 diabetes and metabolic syndrome are two conditions that carry dangerous health risks. Diabetes is a metabolic disease in which the body can’t use the glucose, or sugar, it creates during digestion.  It remains in the bloodstream and leads to high blood sugar, or hyperglycemia. Unmanaged, high blood sugar damages nerves and blood vessels and can lead to loss of vision, limbs, organ functioning—and life. Like diabetes, metabolic syndrome is another dangerous health condition.

Metabolic syndrome, sometimes called Syndrome X, insulin resistance syndrome, or dysmetabolic syndrome, is a group of conditions that together wreak havoc on our health. Metabolic syndrome involves these general disorders and conditions:

• Elevated blood sugar levels (prediabetes)
• High cholesterol
• High triglyceride levels (fats in the bloodstream)
• High blood pressure
• Excess abdominal fat

Each of these health concerns can stand alone, and when someone has just one it poses health risks; however, when someone experiences multiple components together, the potential for harm rises significantly.

Why Preventing Type 2 Diabetes and Metabolic Syndrome is Important

The conditions occurring together in metabolic syndrome carry dire consequences. People with metabolic syndrome are in danger of developing:

• Cardiovascular disease
• Heart attack
• Stroke
• Type 2 diabetes

These develop thanks to damage done by metabolic syndrome:

• Artery damage
• Kidney changes, including a decreased ability to remove salt
• Blood clots
• Decreased insulin production, indicative of the start of type 2 diabetes

These health problems can be frightening. Knowing if you’re at risk can help you understand what’s in store.

Who Gets Metabolic Syndrome?

Metabolic syndrome affects about 23 percent of adults in the US (American Heart Association, 2016). The risk for this condition increases with age; 40 percent of people in their 60s and 70s have metabolic syndrome. People who are obese and have features of insulin resistance, such as skin changes, have an increased risk of both type 2 diabetes and metabolic syndrome.
 
To be diagnosed with this syndrome, people must have at least three of the following:

• Abdominal obesity (a 40” waist in man and a 35” waist in women)
• Blood pressure with a 130 mmHg systolic (top) reading or an 85 mmHg diastolic (bottom) reading
• Fasting blood glucose level of 100 mg/dL or higher)
• HDL (“good”) cholesterol level less than 40 mg/dL in men or less than 50 in women

Metabolic syndrome is dangerous, as is diabetes. When we understand the causes, we can learn how to prevent them from developing.

The Causes of Metabolic Syndrome and Type 2 Diabetes are The Keys to Prevention and Health

The best way to treat these disorders is to prevent them from occurring in the first place. But even if you have already been diagnosed with diabetes or metabolic syndrome, you can stop the progression of damage to prevent other associated health problems.

Preventing them involves knowing the causes and working to reverse them. Causes include:

• Insulin resistance (the body doesn’t use its insulin efficiently, resulting in hyperglycemia)
• Overweight and obesity
• Sedentary lifestyle
• Poor sleep
• Genetic factors
• Older age

All of these can be controlled and prevented, including, to some extent, genetic factors and age. Of course, you can’t change your genetic makeup or your age, but you can compensate for them and minimize their negative impact with the same actions you take to prevent the other factors.

A healthy, balanced diet high in nutrients and low in processed foods and sugar is essential. Adding or increasing physical activity plays a huge role in preventing or managing metabolic syndrome and type 2 diabetes. Weight management is crucial, too, and when you eat well and exercise, weight loss occurs naturally.

Lifestyle changes are the most powerful way to prevent metabolic syndrome and diabetes. Sometimes, such changes alone aren’t enough to manage some of these conditions, so doctors may prescribe medication designed to lower blood pressure, cholesterol, triglycerides, or blood sugar. These are never meant to replace lifestyle factors. How you live and the choices you make for your health are the most potent means of prevention.

American Heart Association and the Life’s Simple 7®

The American Heart Association has created a plan for a healthy heart and healthy life called Life’s Simple 7®. Following the simple plan drastically reduces your risk of metabolic syndrome, type 2 diabetes, and all of the health problems associated with them.

These seven lifestyle steps can help you reclaim your life. Trying to incorporate all of them at once can be overwhelming, so feel free to start small and gradually increase. More details are on the Life’s Simple 7® page. Here are the seven prevention tips suggested by the AHA:

• Manage blood pressure
• Decrease blood sugar
• Control cholesterol
• Be active
• Eat healthy
• Lose weight
• Stop smoking

Keep your ultimate goal in mind: your version of a long, healthy life with the ability to do what’s important to you. Not only can you stave off metabolic syndrome and diabetes, but you can also greatly improve overall physical and mental health.

See Also:

• Atypical Antipsychotics, Stomach Fat and Metabolic Syndrome
• Metabolic Syndrome: Those with Schizophrenia and Bipolar Disorder at Highest Risk

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Diabetes is a medical cause of psychosis. Diabetes is an illness with many complications, including psychotic symptoms and other psychiatric conditions. Problems with glucose (sugar) are at work in diabetes and its effects. When you eat, your body digests carbohydrates into glucose. This sugar is released into the bloodstream in order to enter the body’s cells for energy. Glucose, though, can’t enter the cells by itself but needs a hormone called insulin to help. In diabetes, something goes wrong with this process. Either the body can’t make insulin (type 1 diabetes) or it doesn’t use the insulin it makes efficiently (type 2 diabetes). In both cases, blood sugar accumulates. Treatment is needed to reduce blood glucose levels, but it’s a tricky process and sometimes blood sugar drops too low. It’s these blood sugar swings, the glucose instability, that connect diabetes and psychosis.

Research studies have identified the link between diabetes and psychosis and the fact that diabetes can cause temporary psychosis; however, the exact mechanism that triggers psychosis is yet unknown. Many things, however, are known: nuances of psychosis including hyperglycemia psychosis and low blood sugar psychosis, and current treatment recommendations.

Diabetes and Psychosis: What is Psychosis?

Psychosis is a term that can be frightening. Thanks in part to Hollywood, it conjures images of people behaving wildly (the stereotypical depiction of “crazy”) and perhaps even violently. This is the stuff of fiction and has absolutely nothing to do with psychosis in diabetes.

Psychosis refers to a state of mind involving confusion between what is real and what is not real. Psychosis is comprised of different experiences: hallucinations, delusions, disordered thinking and difficulty concentrating, confusion, and disorganized speech or behavior.

Two categories of psychosis exist. Primary psychosis involves psychotic symptoms that are part of a psychiatric disorder such as schizophrenia ("The Strong Link Between Schizophrenia and Diabetes"). Secondary psychosis refers to psychotic symptoms that develop because of a medical condition. Diabetes is an example of secondary psychosis.

General secondary psychotic symptoms—like those in diabetes—primarily include:

• Visual hallucinations
• Delusional thinking
• Confusion

In diabetes, hyperglycemia (high blood sugar) and hypoglycemia (low blood sugar) are the two conditions that can cause psychosis. However, one of them is a bigger culprit than the other.

Hypoglycemia and Psychosis

Low blood sugar psychosis is much more common than high blood sugar psychosis. When the body’s glucose levels drop below 70 ml/dL, dangerous symptoms begin. Among the psychotic symptoms of hypoglycemia are

• Confusion
• Scattered thoughts
• Delirium
• Visual hallucinations
• Delusional thinking

Hyperglycemia and Psychosis

The other blood sugar extreme involves blood glucose levels that are dangerously high. Because hypoglycemia can cause psychosis, people often wonder if high blood sugar can cause psychosis, too.

While elevated blood sugar does cause problems, including cognitive functioning, poor judgment, difficulty making decisions, and information processing, psychotic symptoms are rare.  Delusional thinking and visual hallucinations are much more common with low blood sugar than with high.

Whether psychotic symptoms arise from hypo- or hyperglycemia, secondary psychosis in diabetes is treatable.

Diabetes and Psychosis Treatment

Even though psychosis in diabetes is temporary and tends to occur in distinct episodes, it’s important to help someone with these symptoms. A holistic treatment approach that addresses diabetes itself and the experience of psychosis is perhaps the most effective way to manage the psychotic experiences of diabetes. Recommended treatment approaches involve:

• Working with the diabetes care team, including the primary doctor, to improve blood sugar control
• Mental health therapy to deal with the delusions, which can often be distressing

Additionally, taking antipsychotics to reduce delusions and hallucinations is not recommended ("Are There Any Safe Antipsychotics in Diabetes Treatment?"). Many antipsychotics cause significant weight gain, which is a major problem in diabetes. Weight gain can disrupt blood sugar control even more, which in turn can lead to more psychotic episodes, not fewer.

Diabetes can indeed cause psychosis, but this secondary form of psychosis comes and goes. Controlling blood sugar so it stays within a healthy range can prevent psychotic episodes and improve quality of life.

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A relatively new eating disorder, "night-eating syndrome," characterized by a lack of appetite in the morning & overeating at night with agitation & insomnia has been reported in a new study. "Not only is night-eating syndrome an eating disorder, but one of mood & sleep as well," said study author Albert Stunkard, MD, of the University of Pennsylvania's Weight & Eating Disorders Program. "People who fall prey to this syndrome are not simply indulging in a bad habit. They have a real clinical illness, reflected by changes in hormone levels."

The study, by a team from the University of Pennsylvania Medical Center & the University Hospital in Tromso, Norway & appearing in today's issue of the Journal of the American Medical Association, is a combination of two related studies based upon behavioral & neuro-endorcine data. The behavioral study, conducted at the University of Pennsylvania School of Medicine, attempts to define the behavioral characteristics of the syndrome in terms of the timing of caloric consumption during eating episodes, level of mood throughout the waking hours & frequency of night-time awakenings. The neuro-endocrine study, conducted at the University Hospital in Tromso, Norway, attempts to characterize the syndrome in terms of circadian profiles (occurring approximately every 24 hours) of plasma melatonin, leptin & cortisol-the hormones linked to sleep & appetite that are found in lower levels in people with night-eating syndrome.

Participants in the Penn & Norwegian Studies were monitored for food intake, mood alterations, sleep disturbances & night-time snacking, as well as hormonal fluctuations. "People with this syndrome start out daily with morning anorexia- or not eating anything all morning- & consume fewer than average calories throughout the day. As the day wears on, their mood worsens & they become more & more depressed," said Stunkard. Then comes the night, when victims raid the refrigerator & cupboards for high-carbohydrate snacks, sometimes up to four times a night. As anxiety & depression increases throughout the night, so does eating. "This snacking may be a way for these persons to medicate themselves," speculates Stunkard, "because they eat a lot of carbohydrates, increasing serotonin in the brain which in turn, leads to sleep."

Night eating syndrome signs and symptoms

* The person has little or no appetite for breakfast. Delays first meal for several hours after waking up. Is not hungry or is upset about how much was eaten the night before.

* Eats more food after dinner than during that meal.

* Eats more than half of daily food intake after dinner but before breakfast. May leave the bed to snack at night.

* This pattern has persisted for at least two months.

* Person feels tense, anxious, upset, or guilty while eating.

* NES is thought to be stress related and is often accompanied by depression. Especially at night the person may be moody, tense, anxious, nervous, agitated, etc.

* Has trouble falling asleep or staying asleep. Wakes frequently and then often eats.

* Foods ingested are often carbohydrates: sugary and starch.

* Behavior is not like binge eating which is done in relatively short episodes. Night-eating syndrome involves continual eating throughout evening hours.

* This eating produces guilt and shame, not enjoyment.

Night-eating syndrome shows distinctive changes in hormones related to sleep, hunger & stress. The nighttime rise in the hormone that accompanies sleep, melatonin, is greatly decreased in night eaters, probably contributing to their sleep disturbances. Similarly, night-eaters fail to show a nighttime rise in the hormone leptin, which suppresses hunger & the stress hormone cortisol is elevated throughout a 24-hour period.

Night-eating syndrome is believed to occur in 10% of obese people seeking treatment for their obesity, which means about 10 million people may be affected. It also does occur among people of normal weight, although less frequently. "Night-eating syndrome may represent a special kind of response to stress that afflicts certain vulnerable people," said Stunkard.

Night-eating syndrome appears to differ from bulimia nervosa and binge eating. Instead of very large & infrequent binges, persons with this disorder consume relatively small snacks at night-about 270 calories-but far more frequently. In addition, their sleep is far more disturbed.

Stunkard believes that defining night-eating syndrome as a new eating disorder will encourage more research, leading to a far better understanding of the disorder. "We study what we define," said Stunkard, who is optimistic such research will lead to effective eating disorder treatments that do not now exist.