While Type 1 and Type 2 diabetes are widely recognized and studied, scientists have proposed two additional forms - type 3 and type 4 diabetes. Though they are not medically or officially classified by any health organizations, these terms have been gaining attention more and more.

Recently, Health and Me reported on the Type 5 diabetes, which is linked to malnutrition. However, the question is, if we already have type 1, 2, and 5 diabetes, then what are the type 3 and 4?

Let's delve a little deeper into that:

What is Type 3 Diabetes?

Type 3 Diabetes is an unofficial term that is used to describe Alzheimer's disease which is caused by insulin resistance in the brain. Researchers first proposed this classification after observing similarities between the brain changes in Alzheimer's and those caused by diabetes.

In healthy brains, insulin usually supports communication between the nerve cells and also helps regulate energy use. However, in people with Alzheimer's, the brain shows signs of insulin resistance, impairing the brain's ability to use glucose properly. This dysfunction can also lead to memory loss, cognitive decline, and the buildup of proteins like tau and beta-amyloid, hallmarks of Alzheimer's disease.

While Type 3 diabetes is not a formally recognized diagnosis, the idea does throw a light on its important link between metabolic health and brain function.

What are the symptoms?

• Memory loss that disrupts daily life
• Difficulty solving problems or planning
• Trouble completing familiar tasks
• Confusion with time or place
• Problems with language and communication
• Losing items or placing them in odd locations
• Poor judgment or decision-making
• Withdrawal from work or social activities
• Mood swings and personality changes

While some of these changes can occur with age, consistent or worsening symptoms should prompt a medical evaluation.

What Causes It?

The idea of type 3 diabetes is based on how insulin dysfunction in the brain may contribute to neurodegeneration. Several risk factors have been identified:

• Diet high in sugar and fat, low in fiber
• Sedentary lifestyle
• Chronic stress
• Low socioeconomic status
• Genetics, including the presence of the APOE4 gene
• High blood pressure and poor lipid metabolism

These factors can impair glucose delivery to the brain and damage neurons, increasing the risk of dementia.

What is Type 4 Diabetes?

It is also another proposed category that occurs in older adults who develop insulin resistance despite not being overweight. In fact, in a 2015 study that involved mice, suggested that this form of diabetes may be caused by accumulation of immune cells called regulatory T cells, which increase with age. The study is titled: Depletion of Fat Tregs Prevents Age-Associated Insulin Resistance.

Unlike type 2 diabetes, which is also linked to obesity, in type 4 diabetes, lean individuals get affected.

Symptoms of Type 4 Diabetes

• Fatigue
• Frequent urination
• Blurred vision
• Unexplained weight loss
• Increased thirst and hunger
• Slow-healing sores

Because it typically affects older adults with normal body weight, these symptoms may be misattributed to aging or other conditions, leading to underdiagnosis.

What Causes It?

The exact causes of type 4 diabetes are still being studied, but aging appears to play a significant role. Research indicates that excess regulatory T cells may interfere with insulin signaling, leading to blood sugar issues in the absence of typical risk factors like obesity.

Sunken faces, hollowed-out eyes, drooping jawlines—these aren't rumors; they're real physical changes seen in patients who experience quick fat loss due to the GLP-1 drug Ozempic and it's not just stopping at the face. The health world is now abuzz with terms like "Ozempic feet" and "Ozempic butt," showing the increasing fear that this hack to being thin could have unexpected physical trade-offs.

Ozempic, a drug initially designed for the treatment of type 2 diabetes, has recently swept the internet, not to treat the condition it was designed for, but with its remarkable off-label effects on weight reduction. Celebrities, social media influencers, and ordinary consumers are using this self-proclaimed "miracle injection" to lose weight quickly.

While the drug is all the rage on social media and among celebrities, experts are sounding alarms over its widespread, off-label usage. Are we settling for instant gratification rather than long-term health and aesthetics? Is Ozempic sneakingly reshaping not only bodies, but also the standards of beauty of an entire generation?

With new beauty trends spreading at lightning speed, a new buzzword taken the wellness world by storm- "Ozempic Face." With social media buzz and gossip about celebrities, the discussion of Ozempic, a type 2 diabetes drug turned off-label weight-loss phenomenon, has moved past glucose levels and waistlines—it's now transforming how we think about facial aging.

Celebrities such as Katy Perry, Lizzo, John Goodman, Karan Johar, Mindy Kaling, Ram Kapoor and even Oprah Winfrey have come under scrutiny for their facial changes reportedly tied to the Ozempic face phenomenon due to the noticeably changes in their faces.

Ozempic is the brand name for semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist produced by drug giant Novo Nordisk. Approved by the U.S. FDA in 2017 for the treatment of type 2 diabetes, it acts by mimicking the effect of GLP-1, a hormone that triggers insulin release, suppresses appetite, and decreases blood sugar.

Although its initial purpose was to regulate blood sugar in diabetic patients, Ozempic's appetite suppressant property gave rise to an unforeseen—though highly marketable—side effect: major weight loss. This off-label application has been widely adopted, particularly in Hollywood and high society, and it has become a first-choice treatment for those wanting quick, pharmacy-facilitated weight loss.

What is Ozempic Face?

While dramatic weight loss tales dominate the wellness feeds, another and more somber trend is being observed: "Ozempic Face." The latter is defined as facial side effects seen on some patients who undergo rapid fat loss, especially in the cheeks, temples, and jaw.

Common characteristics of Ozempic Face are:

• Sunken eyes and circles under the eyes
• Hollowed cheeks and temples
• Loose jowls and loose skin of the neck
• Enhanced prominence of fine lines and wrinkles

What makes this effect so dramatic is not only the transformation of body shape, but also the accelerated aging effect on the face, which can cause users to look gaunt or exhausted, even though their overall health indicators are getting better.

What Causes Ozempic Face?

While the name is catchy, Ozempic itself is not to blame—instead, it's the rate and amount of weight loss that leads to the facial alterations. The disappearance of subcutaneous fat from the face—fat that previously contributed volume and youthfulness—results in a more gaunt look. This is why it occurs:

Facial fat depletion: Fat loss is not confined. When you lose weight, you lose fat all over—yes, including the face.

Reduced skin elasticity: With age, the skin loses collagen and elasticity, making it harder to rebound after volume loss.

Rapid weight loss: When the transformation happens quickly, the skin doesn't have time to adjust, causing sagging and wrinkling.

It's also a side effect that appears in other GLP-1 medications or any rigorous calorie-cut weight reduction regimen. It's not unique to Ozempic—but the medication's growing popularity makes it a familiar case study.

Another strange side effect of the slimming drug is 'Ozempic feet' which is a described as\t the sloping, creased skin and hollow look of the feet especially at the top, where the skin naturally thins. This is a result of an extreme and rapid depletion of fat stores as the patients lose weight. Unlike intentional body sculpting or fat reduction from exercise, weight loss with Ozempic is fast and even, subjecting areas that typically have small fat reserves, such as the feet. Although weight loss is something to be cheered, the psychological cost of Ozempic Face is never talked about. Users say that they feel more self-conscious after they've reached their weight loss goal because of the unforeseen changes in their looks. In a society where youthfulness is highly valued, the side effects are extremely unsettling.

This has resulted in an increase in consultations with cosmetic surgeons and dermatologists, with the patients opting for fillers, tightening procedures for the skin, and even facelifts to counteract the effects of their prescription weight loss process.

Can You Prevent or Reverse Ozempic Face?

While it's impossible to prevent it completely, there are measures one can take to reverse the effects of Ozempic Face, especially if patients take a pro-active approach:

Gradually lose weight: Work closely with your doctor to adjust your dose and take a slower rate of weight loss.

Stay well-hydrated: Drink 1 to 2 liters of water per day to support skin health.

Make protein a priority: Eat a diet that includes lean meats, eggs, legumes, and fish to help support skin structure and elasticity.

Skincare regimen: Add collagen-stimulating and moisturizing products to your routine to enhance skin resilience.

Discuss aesthetic treatments: For more substantial changes, such as dermal fillers, radiofrequency tightening of the skin, and laser therapy, will restore lost volume and tighten lax skin.

Increased use of Ozempic off-label is challenging for healthcare practitioners. Although it can assist in weight control, extensive counseling is essential. The providers need to make sure the patients are informed about the potential physical and psychological effects—not simply the advantages.

In the meantime, those considering using semaglutide to slim down need to be told all about its body-wide effects, not just its effect on weight.

Ozempic craze has highlighted a deeper societal paradox- to become thin over the value we place on youthfulness. Although it may shrink waistlines, it does so at the risk of unintentionally aging the face—exposing the complex costs of modern standards of beauty.

For the millions of people globally, "healthy eating" is a privilege rather than a default choice. From high costs of healthy foods to nutritious food systems that favor profit over health, the obstacles to a liver-supportive diet are real. Among popular diets, the ketogenic diet, or keto, has become extremely popular for its fast weight loss advantages but beneath its high-fat, low-carb framework is a less-discussed issue—how prolonged ketosis can silently burden the liver.

Your liver is your body's control center for detoxification and metabolic regulation. It processes toxins, digests nutrients, produces bile to break down fats, stores energy, and even produces blood-clotting factors.

“While many factors shaping our diet lie outside personal control—like zoning laws, school meal policies, and labeling—what remains in our hands is the knowledge of how our food choices impact our health,” says Nutritionist and Diabetes & Inflammation Specialist, Khushboo Jain Tibrewala.

However, these processes can be easily undone by modern lives—too much booze, sweet diets, lazy lifestyles, and, ironically enough, some hardcore dietary regimes like prolonged keto. The liver's tough, true, but get it working around its metabolic tipping point for sustained periods, and it begins to exhibit symptoms—a lot of which come in the form of abnormal liver enzymes and inflammation.

What Is Ketosis?

Ketosis is a metabolic process by which your body shifts from glucose (carbohydrate) to fat fueling. Carbohydrates in your diet, under normal conditions, get digested into glucose, which gets utilized by the body as fuel. In ketosis, fats are metabolized into ketone bodies—an additional fuel for brain and muscle tissue.

As per Tibrewala, this condition can be triggered by, "A ketogenic diet—intentionally low in carbohydrates and high in fat, or in severe cases of uncontrolled diabetes, where glucose metabolism is disturbed."

Although created initially to control epilepsy, the keto diet is today mainstream. Individuals remain in ketosis for weeks, months, even years. But is such long-term adaptation liver-friendly?

Overburdening the Liver

"The liver is at the center of making ketones," Tibrewala says. "And that process of metabolism is taxing." Sustained levels of ketosis lead to the liver breaking down fats continuously, which in turn increases liver enzymes—namely ALT (alanine aminotransferase) and AST (aspartate aminotransferase).

Clinical research indicates that keto dieters who eat this way in the long term tend to develop signs of hepatic stress even when they do not have fatty liver disease. High enzymes don't necessarily mean instant damage to the liver—but they do signal that the liver is burning out. Left untreated, this can result in inflammation, fibrosis, or even non-alcoholic steatohepatitis (NASH) in vulnerable people.

Low-Carb, Low-Fibre

A significant downfall of ketosis is the drastic reduction of dietary fibre, a substance which is rich in carb-foods such as fruits, whole grains, and legumes. "Fibre is not only for digestion—it's food for your gut microbiome," adds Tibrewala.

A fiber-deficient diet upsets the balance of bacteria in the gut, permitting deleterious strains to dominate. The outcome? Increased permeability of the gut, systemic inflammation, and toxic load—altogether placing further stress on the liver. The organ is thus forced to struggle even harder to detoxify these toxins, added to its already high workload under ketosis.

Hidden Harm of Processed Keto Products

Ironically, most keto believers resort to processed foods to fulfill their macronutrient needs. From protein powders and MCT oils, snack bars, to exogenous ketone supplements, they are filled with preservatives, additives, and in some, heavy metals.

"These artificial substances are processed through the liver, which is yet another source of stress," Tibrewala observes. Gradually, this higher toxic load—combined with compromised gut integrity—can drive the liver toward pathology, even if there are no obvious symptoms.

Therapeutic vs. Trendy: When Does Ketosis Make Sense?

It’s important to acknowledge that ketosis, in short, supervised intervals, may have therapeutic potential—particularly for managing epilepsy, obesity, or insulin resistance. But long-term, unsupervised ketosis can be a slippery slope.

A liver in constant ketone-production mode is analogous to a machine running non-stop—it wears out faster. “Our liver thrives on balance, moderation, and nourishment—not on extremes,” emphasizes Tibrewala.

What Can You Do for Your Liver?

Select balanced nutrition: Eat whole grains, plant protein, and high fibre foods.

Steer clear of ultra-processed keto treats and go for whole-food fats such as avocado, nuts, and seeds.

Restrict ketosis to short cycles, if at all, and always after consulting a health professional.

Emphasize gut health with probiotics, prebiotics, and fermented foods. A healthy gut lightens the burden on your liver.

Drink water and move around—two simple but potent aids to liver detox and metabolic equilibrium.

In the quest for weight reduction or "biohacking," extended ketosis has been hailed as revolutionary but your liver- the powerhouse of your metabolism tends to take the hit.

Khushboo Jain Tibrewala is a Nutritionist and Diabetes & Inflammation specialist at The Health Pantry in India

Waking up can be a big deal at times, sometimes it is because you slept late, others it can be due to fatigue or illness. Many people assume that as long as you are sleeping on time you should be able to wake up with no problem, but people who have difficulty falling asleep and others who have odd working hours do not have the luxury to fall asleep whenever they please. To understand how to fall asleep and wake up feeling refreshed, you must understand the different aspects that affect a good night’s sleep.

If you often wake up feeling tired, it's likely you're not getting enough quality sleep. Simple lifestyle adjustments can significantly improve your sleep and make mornings easier. However, if persistent fatigue is due to an underlying medical condition, a combination of home remedies and professional treatment may be necessary.

Important Aspects Of Sleep Health

Your body loves routines, especially when it comes to sleep. Going to bed and waking up at the same time every day, even on weekends, tells your body when it's time to rest and when it's time to be awake, think of it like setting an internal clock. Most adults need around seven to nine hours of sleep each night to feel rested. If you go to bed and wake up at odd and different hours, your body gets confused, and you might wake up feeling tired. Sticking to a regular sleep schedule helps your body naturally prepare for sleep and wake up feeling refreshed.

Create a Relaxing Bedtime Routine

To get good sleep, your brain needs to know it's time to rest. Looking at bright screens before bed can keep you awake for longer and disrupt your sleep. Instead, do things that help you calm down like read a book or take a warm bath, even quiet music can help.

Avoid coffee or alcohol at night, as they mess with sleep. A relaxing routine helps you fall asleep faster and sleep better. This means you'll wake up feeling more rested and ready for the day.

Move Your Alarm Clock

Hitting snooze makes you more tired, not less. When you fall back asleep, your sleep gets broken, and you don't rest well. Put your alarm across the room, this forces you to get up to turn it off. Getting out of bed right away helps you wake up properly. You won't fall back asleep and feel even more tired. Starting your day right away makes you feel more awake and ready.

Improve Your Diet

What you eat matters for sleep, healthy foods like fruits and veggies help you sleep better. Avoid sugary snacks and processed foods, especially at night; they can keep you up. A balanced diet helps your body work well, which improves sleep. Don't eat big meals before bed; your body works hard to digest them, which keeps you awake. Eating healthy and at the right times helps you rest better.

Engage in Regular Exercise

Being active during the day helps you sleep better at night- walking or cycling uses up energy, making you tired at bedtime. Don't exercise too close to bedtime; it'll keep you awake for longer. Exercise during the day or early evening. Even a little exercise helps you sleep better. You'll fall asleep faster and sleep more deeply. This means you'll wake up feeling more refreshed.

Get Sunlight Exposure

Sunlight tells your body when it's day or night. Morning sunlight sets your body's clock, helping you sleep at night. Open your blinds or go for a walk outside. Even on cloudy days, turn on the lights. Try having breakfast outside. Sunlight in the morning helps you feel awake during the day and sleep better at night.

Consider a Sleep Study

If you still can't sleep well after trying everything, talk to your doctor about a sleep study. It can find out if you have a sleep disorder like sleep apnea or insomnia. These disorders make it hard to sleep, even if you do everything else right. A sleep study watches you sleep and helps doctors find the problem, they can then help you get the right treatment.

Treat Underlying Sleep Disorders

If you have a sleep disorder, getting treatment helps you sleep much better. There are many treatments, like medicine or breathing machines. Your doctor will help you find what's right for you. Treating a sleep disorder helps you sleep better and feel more rested. It also makes you healthier overall.