Diabetic Brains

The standard form of diabetes mellitus (DM II) that affects 11-24% of the U.S. adult population is commonly discussed as a problem of elevated blood sugar primarily caused by obesity.  Unfortunately, this version is very outdated.

A steady stream of research demonstrates that diabetes is a chronic condition resulting from the deterioration of brain function, which causes cognitive impairment. Brain structure deteriorates, and then the symptoms of obesity and abnormal blood sugar regulation follow.

Brain Deterioration Causes Body Deterioration

Unrepaired damage to the brain sets into motion the deterioration of the body.  People need to be aware of the effects diabetes has on the brain and the aging process as measured by Autonomic Nervous System testing.  More importantly, people need to know that the Autonomic Nervous System is now capable of improvement or repair.

The Autonomic Nervous System is the brain’s communication network that regulates hunger, where and how body fat is deposited, many hormones including insulin, and the hunger hormones leptin and ghrelin. When the Autonomic Nervous System function deteriorates the brain’s hunger, glucose, and body fat regulation systems falter.  This is when body fat increases and blood sugar levels rise.

Increased levels of hunger, thirst, abdominal fat, fatigue, blood sugar, and blood pressure regulation problems are the result of Autonomic Dysfunction from metabolic inflammation.  Simply put, these are symptoms of brain deterioration due to increased inflammation.

Diabetes Accelerates Brain Aging

Diabetics are suffering from premature aging of their brains with deterioration of their Autonomics, up to a 50 – 80% reduction of Autonomic Nervous System function over the first two decades.

In other words, diabetics may reach Stage 5 Autonomic Dysfunction, cardiac autonomic neuropathy (“CAN”), nearly two decades earlier than people of the same age who do not have diabetes.

The rapid aging of diabetic brains is easily measured through Autonomic Nervous System testing. It is important to detect and stabilize advanced Autonomic dysfunction because CAN, if left untreated, has a 50% mortality rate in 5 years.

The importance of Autonomic testing to identify CAN is not new information to the medical community.  In the 2010 Standards of Care, the American Diabetes Association stated that screening for signs and symptoms of cardiovascular autonomic neuropathy (CAN) should be instituted at the time of diagnosis of type 2 diabetes and within five years after the diagnosis of type 1 diabetes (Diabetes Care, Volume 33, Supplement 1, January 2010, page S37).

Yet many diabetics and their physicians have never heard of cardiac autonomic neuropathy, even though it is responsible for sudden death syndrome, the most common form of death for diabetics.

Diabetes Diagnosis Criteria

Education about the diabetic pathway may help people take steps to prevent the disease.

How do we know if we have developed type II diabetes?  Many people become aware of the disease process when blood glucose test numbers identify them as “pre-diabetic,” which is a state of impaired glucose tolerance.  This is an essential window of time in which substantial changes to one’s diet can halt or reverse the impaired glucose tolerance process, such as dropping one’s daily total intake of carbohydrates and sugar below 100 grams daily.

Four words sum up the disease at this point: diabetes is carbohydrate poisoning.  Diet is so essential that the medical treatment for diabetes back before the invention of insulin was a low-carbohydrate diet.

But today, too many people misunderstand this phase and think they are “just” pre-diabetic on blood work, so they “wait” until their numbers get worse to “do” something (pills or insulin).  But in the pre-diabetic stage, people have already begun to experience decreased Autonomic Parasympathetic modulation of their heart. That means the pre-diabetic brain has already started having trouble controlling the heart through the Autonomic Nervous System.

Valuable time is lost when someone waits to pass from being pre-diabetic to the diabetic range on a lab test.  That lab result is simply a number on a piece of paper that alerts us when excess sugars in the body transition from being toxic to the sugars that actually cause disease themselves.

Choose the Comprehensive Blood Test

People may better understand what is happening within their bodies if they choose the most informative blood test. Two blood tests are given to check for diabetes, and people should know the difference to request the Hemoglobin A1c test, which is newer and more accurate.  Poorly trained healthcare professionals need help understanding the tests or the bigger picture of disease and organ damage.

The first testing method is the old Fasting Blood Sugar testing on a basic blood panel. Still, this test is limited and only measures the liver’s ability to properly make or maintain blood sugar while sleeping the night before your test.  It does not reflect what will happen after you eat, like how high or low your sugars will go.

The other test, which is minimally more expensive, is the Hemoglobin A1c.  This test is the most accurate measure of glucose regulation because it averages your blood sugar over the last three months.  It measures advanced glycation end products (“AGEs”) from elevated blood sugars.

With only a limited look at blood sugar (fasting blood sugar) and not an extended 3-month look at blood sugar (HgbA1c), many people do not realize they are slipping into pre-diabetes, and their opportunities for prevention and intervention are lost.

An A1c of 5.6 or less is normal, 5.7 – 6.4 is pre-diabetic, and 6.5+ is diabetic.  But when someone reaches 6.5 and is officially diagnosed with diabetes, half of their pancreas has already been destroyed.  The blood tests are way behind the silent destruction.

The Autonomic Nervous System and Diabetes

The second part of understanding the diabetic brain is found in a network called the Autonomic Nervous System. Autonomics control every organ in the body, such as the heart, bladder, stomach, intestines, and kidneys.  It is how the brain regulates blood pressure, blood sugar, sleep cycles, the immune system, and hormones.

There are two main branches in the Autonomic Nervous System.  In simple terms, the Sympathetic branch is responsible for energy expenditure (“fight or flight”), and the Parasympathetic branch is responsible for energy conservation and restoration (“rest and digest”).

These two opposite Autonomic branches should work together simultaneously and in balance.  But a number of things are damaging the Autonomic Nervous System and causing patterns of weakness or excess in one or both branches too early in diabetics.

Autonomic function naturally declines with age, but it has become clear to me over the past 11 years that our Autonomics have become increasingly prone to injury and dysfunction after some accumulation of stress, poor nutrition, chemicals in our foods, childbirth, intestinal infections, and both physical and emotional concussions and traumas.

When the Autonomics fail to work properly, the body’s response to disease and stress is impaired. The brain develops problems that include maintaining normal heart rhythms, blood pressure, brain oxygen delivery, moving the digestive tract, and proper organ and immune function.

If the “fight or flight” Sympathetic brain commands are disrupted, people may feel tired, crave salt or sugar, experience excessive hunger, or get anxious. People may get heart palpitations, tingling or numbness in their arms (hands or face), disrupted night vision, varicose veins, E.D., stiff necks and shoulders, severe (“migraine”) headaches, or insomnia.

If the “rest and digest” Parasympathetic brain commands are disrupted, they may affect the intestinal tract (heartburn or constipation), and immune system (autoimmune disorders), and produce chronic pain syndromes (fibromyalgia). People may get sleep apnea, “restless legs”, morning nausea, night sweats/hot flashes, power surge sensations when they should be at rest, or non-restorative sleep.

There are five stages in Autonomic Dysfunction. In Stage 3, people experience symptoms that affect their daily life, like GI trouble, sleep trouble, headaches, temperature regulation problems, or dizziness.

Stage 4 and Stage 5 Autonomic Dysfunction is the result of progressive deterioration.

Spectral analysis Autonomic testing measures the weakening of one or of both the Autonomic branches.  This is essential diagnostic information for diabetics to know because they may develop weak Autonomic patterns years or decades too early than the natural rate of aging.

Advanced Autonomic Dysfunction

Extreme Autonomic imbalance, Stage 5 Autonomic Dysfunction, is cardiac autonomic neuropathy (CAN) with a 50% mortality rate in 5 years.  This Autonomic pattern places diabetics at risk of cardiac events, including when the Autonomics are artificially suppressed, like when someone has gone to sleep under anesthesia.

Diabetes prematurely accelerates the ability of the brain, through the Autonomic Nervous System, to properly control the heart (leading to CAN = increased risk of sudden death).  The Autonomic Nervous System balance must be restored to reverse CAN and restore average aging.

The first step is identifying Autonomic Dysfunction and CAN and then stabilizing them with medication when necessary.  The second step is to lower metabolic inflammation in the body and brain with every tool available.  Reducing inflammation is greatly accomplished by critical shifts in diet, food quality, and cooking methods.  This is how people make their kitchens more potent than the operating room.

Metabolic inflammation is the cumulative effect of a variety of problems.  Excessive omega-6 fatty acids (vegetable oils) and deficient omega-3 fatty acids (DHA, ALA, EPA) in our foods are believed to be of significant global triggers of obesity and diabetes.  Compounding this is an imbalance of intestinal bacteria (SIBO) and the ingestion of chemicals referred to as AGEs (advanced glycation end products).

AGEs are formed from heating sugar and protein molecules at high cooking temperatures and are often found in commercially prepared foods.  The higher and longer the temperature during cooking, the more AGEs are formed.  Simply cooking foods at lower levels results in lower blood sugar levels for diabetics.

If you are diabetic or pre-diabetic, you need to reduce your levels of inflammation to maintain a brain that can function more normally.  By lowering inflammation enough, your Autonomic Nervous System can recover, and this improvement can reduce blood sugar, blood pressure, hunger levels, and body weight.

Fixing the brain to fix the body takes persistent effort by the patient. Still, I have guided Autonomic recovery even in diabetics who presented in my office with advanced Stage 5 Autonomic Dysfunction.

Remember, it is the failure of the brain is that sets into motion the failure of the body.  And we can reverse CAN.

This post is provided as an information resource and is not to be used or relied on for diagnostic or treatment purposes. This information is not intended to be patient education and does not create any patient-physician relationship.