What Is Type 3 Diabetes? Insulin Resistance In The Brain That Could Trigger Alzheimer’s
Most people are aware of type 1 and type 2 diabetes, but did you know there is a type 3 diabetes as well! It is a more obscure term. Although it is not an accepted medical diagnosis, type 3 diabetes has been discussed in the literature as a possible relationship between insulin resistance in the brain and Alzheimer's disease. This link has been described to help explain how metabolic disorders impact brain health, causing cognitive decline and dementia.
Type 3 diabetes is more of a misnomer because it should not be confused with type 3c diabetes, which relates to pancreatic dysfunction. The term "type 3 diabetes," on the other hand, has been loosely used by some scientists to analogously propose that Alzheimer's disease is strongly implicated with insulin resistance in the brain.
This concept was conceptualized by Dr. Suzanne de la Monte and Dr. Jack Wands of Brown University in the year 2008. This hypothesis postulated that Alzheimer's disease may be called type 3 diabetes for it bears many similarities with glucose metabolism disorder type 2 diabetes. Their concept arises from the basic principle that insulin is fundamental to blood sugar regulation, but it is also the case with the brain. When brain cells become insulin-resistant, they lose access to glucose, impairing their function.
Research published in the Journal of Diabetes Science and Technology supports this hypothesis by indicating that insulin resistance can be a significant contributor to the occurrence of dementia, also referred to as Alzheimer's. The symptoms of memory loss and diminished reasoning are associated with impaired glucose metabolism in the body, especially in the cerebral tissue.
Although type 3 diabetes is not a "medical term," its symptoms correlate well with Alzheimer's diseases that are known to reduce the ability to think in an efficient manner and bring down brain health. These signs are:
- Loss of memory, especially short-term.
- Poor judgment and judgment ability
- Failure in recognizing people or places familiar once.
- Failure in the process of reading, writing or processing numbers
- Anxiety, agitation, or mood changes.
- Disorganized thoughts or confusion
- Lack of impulse control
As the disease advances, patients may be afflicted with severe complications including an inability to swallow or control their bodily functions. In the final stages, most patients die from fatal complications such as aspiration pneumonia.
This may not be well understood with regards to type 3 diabetes, or the exact link between insulin resistance and Alzheimer's disease. Some identified contributing factors include the following:
Insulin acts as an important regulatory mechanism of brain functions such as memory and cognition. The reduction in insulin signaling may impair metabolism of brain cells, thus bringing about neurodegeneration.
These diseases show a strong relationship and those individuals diagnosed with type 2 diabetes have double chances of getting Alzheimer's. In the two, the main causes can be chronic inflammation, oxidative stress, and a defect in glucose metabolism.
Insulin resistance associated with obesity, stress, and an unhealthy diet is considered a cause that may increase the chances of Alzheimer's disease.
Researches in Frontiers in Neuroscience and The Lancet Neurology have also highlighted that drugs used for antidiabetic medication may be crucial for the prevention or at least slowing down the course of Alzheimer's.
In 2022, in a study in Pharmaceuticals, researchers studied biomarker uptake in brain regions implicated in the faulty uptake and metabolism of blood sugar in Alzheimer’s patients.
Emerging Therapies
Research into such treatments as intranasal insulin has also been promising. Intranasal delivery of insulin directly to the brain has been reported to enhance glucose uptake by brain cells, improve memory, and boost cognitive performance. While such clinical trials have been shown to be successful, additional research is needed for safety and efficacy.
Medications
For patients being aggressive or agitated, antipsychotic drugs may be prescribed; however, therapies such as cognitive rehabilitation as well as cognitive stimulation therapy serve to preserve memory and executive function.
Lifestyle Interventions
Diet, exercise, and stress management are critical in preventing and managing insulin resistance. A review in the Journal of Alzheimer's Disease also highlighted the benefits of Kirtan Kriya meditation, which can regulate genes involved in insulin and glucose metabolism, improve sleep, and reduce inflammation.
Although type 3 diabetes is not officially recognized, its connection to Alzheimer’s disease underscores the importance of proactive measures for brain health. Some prevention strategies include:
1. Healthy Diet
Consuming a balanced diet rich in antioxidants, whole grains, and healthy fats may support brain health.
2. Regular Exercise
Physical activity improves insulin sensitivity, reduces inflammation, and enhances overall metabolic health.
3. Stress Reduction
Mindfulness practices, including meditation, have been shown to lower stress levels, which can reduce the risk of cognitive decline.
The term type 3 diabetes brings out the complex relationship between metabolic disorders and brain health. Even though it is not a recognized medical condition, the concept emphasizes the crucial role of insulin in brain function and its possible contribution to Alzheimer's disease. Continued research will hopefully provide hope for therapies such as intranasal insulin and lifestyle modifications.
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Pope Leo XIV’s lung cancer diagnosis has raised questions about whether a lung nodule always signals cancer.
The 71-year-old pontiff announced in a post on X this week that doctors had detected a small, localized lung nodule during medical examinations. The nodule was detected at a very early stage, and doctors recommended surgery to remove it.
According to Vatican News, surgeons at Gemelli Hospital removed the lower lobe of his right lung using a video-assisted technique. Examination of the tissue confirmed lung adenocarcinoma, the most common subtype of non-small cell lung cancer (NSCLC), accounting for roughly 40% of lung cancer cases.
“An intraoperative histological examination confirmed the diagnosis of lung adenocarcinoma, as suspected from the preoperative examinations,” the statement said.
But does finding a lung nodule always mean cancer? HealthandMe spoke to experts to understand which nodules need further investigation and what warning signs to watch for.
Also read: Pope Leo XIV Will Undergo Lung Nodule Surgery: When Does Removal Become Necessary
A lung nodule is a small, localized spot in the lung, usually detected during a chest X-ray or CT scan. Most are benign, but some may indicate early lung cancer.
Dr Dipanjan Panda, Senior Consultant, Medical Oncology, Indraprastha Apollo Hospital, Delhi, told HealthandMe, that lung nodules can develop for several reasons, including infections, inflammation and, in some cases, cancer.
Doctors assess a nodule’s size, shape, density and growth, along with the patient's age, smoking history and other risk factors. Depending on these findings, they may recommend follow-up CT scans, PET-CT imaging or a biopsy.
“A lung nodule is not synonymous with cancer. Most nodules are benign, often related to previous infections or scarring. Their size, appearance, growth, and the patient’s risk factors determine whether surveillance with repeat CT, PET-CT, or biopsy is needed. The key is appropriate risk assessment, not panic or unnecessary testing,” Dr Karn Mehra, Senior Consultant and Unit Head, Advanced Lung Failure and Transplant Pulmonologist, Fortis Hospital, Manesar, told HealthandMe.
Read More: Lung Nodule on CT Scan? Doctors Explain When You Should Worry
Dr Raajit Chanana, Director and Senior Consultant, Medical Oncology, Dharamshila Narayana Superspeciality Hospital, Delhi, highlighted several factors that may raise concern about malignancy:
Although tobacco remains a major risk factor, lung cancer can also develop in people who have never smoked.
Dr Mehra noted that lung cancer in never-smokers is increasingly being recognized, including among younger adults. Air pollution, occupational exposures and genetic susceptibility may also contribute to the risk.
However, living in a polluted city alone does not justify annual CT scans. Screening should follow established risk criteria, particularly those based on age and smoking history. Low-dose CT can detect early lung cancer in eligible high-risk individuals, while indiscriminate scanning can lead to radiation exposure, false-positive results and unnecessary procedures.
READ: Dry Cough, Breathlessness May Not Always Be Asthma — Could It Be ILD?
Once lung cancer is confirmed, doctors determine its subtype, stage and molecular profile to guide treatment. Depending on these findings, treatment may include surgery, radiotherapy, targeted therapy, immunotherapy or chemotherapy.
For nodules not confirmed as cancer, management depends on their size, appearance, growth and the patient's risk factors. Small, low-risk nodules may require periodic CT scans, while suspicious ones may need further imaging or a biopsy. Not every nodule requires an invasive procedure.
“A lung nodule is not a cancer diagnosis, but it should never be ignored. Completing recommended follow-up scans is crucial. Quitting smoking remains one of the most effective ways to reduce lung cancer risk. Long-term smokers aged 50 and above should discuss whether they qualify for annual low-dose CT screening,” Dr Chanana said.
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Short-term exposure to air pollution may increase the risk of hospitalisation for several serious health conditions, including cancers and mental disorders, according to a new landmark multicountry study published in The Lancet Planetary Health.
Researchers analysed 346.5 million hospitalisation records from 949 communities across six countries and territories, which included Australia, Brazil, Canada, Chile, New Zealand and Taiwan.
The study examined the relationship between short-term exposure to fine particulate matter (PM2.5) and hospital admissions between 2000 and 2019.
The findings revealed that every 10 micrograms per cubic metre (μg/m³) increase in PM2.5 concentration was associated with an 8% higher risk of hospitalisation from any cause. It was the strongest for malignant neoplasms, or cancers, followed by mental disorders.
The researchers also found that the increased risks associated with short-term exposure could persist for up to 21 days.
Also read: Can Delhi’s Air Pollution Increase GI Cancer Risk? Doctors Report Patients As Young As 15
Among the disease categories examined, malignant neoplasms showed the strongest association with short-term PM2.5 exposure, with a 10.8% higher risk of hospitalisation for every 10 μg/m³ increase in particulate matter concentration.
It was followed by mental disorders, which showed a 10% higher risk. Other neoplasms were linked with a 9.6% increase, while nervous system diseases showed an 8.5% increase.
Respiratory diseases, that were commonly prevalent with air pollution, showed a 6.7% increase in hospitalisation risk.
These findings suggest that the health consequences of polluted air may not just be limited to lungs. They could affect people with a wide range of medical conditions.
However, the researchers assessed hospital admissions, not the occurrence of new diseases. Hence, they found that increases in PM2.5 exposure could increase the likelihood of hospitalisation among people affected by these conditions.
Also read: Delhi Smog: Can You Really Tackle Pollution Season With An N95 Mask And Air Purifier?
The researchers found that hospitalisation risks related to pollution were lower during 2010-2019 than in 2000-2009. Using the World Health Organization's daily PM2.5 guideline of 15 μg/m³ as a reference, the estimated proportion of hospitalisations due to exposure declined from 8.9% to 3.9% between the two decades.
Despite this improvement, the associations remained significant across all disease categories. The study had limitations, including substantial differences in effects across different countries and territories. Its findings also cannot automatically be generalised to regions that were not included, including India.
The researchers concluded that reducing PM2.5 exposure remains an important public health measure to lower hospitalisation risks. Cleaner transport, stricter industrial emission controls and lower reliance on polluting fuels could help limit exposure and the significant health burden that comes with it.
The researchers also said that the effects of short-term PM 2.5 exposure on hospital admissions could persist for up to 21 days after exposure.
PM2.5 refers to fine particulate matter measuring 2.5 micrometres or less in diameter. These particles can come from vehicle exhaust, industrial emissions, construction activities, power generation and the burning of fuels and biomass.
Because of their small size, PM2.5 particles can penetrate deep into the lungs, with some components entering the bloodstream. Exposure can trigger inflammation and oxidative stress, potentially affecting multiple organs.
Despite the observation, the study does not prove that short-term exposure to air pollution increases the risk of serious diseases like cancer. Stronger air-quality monitoring, improved cancer registries and studies linking data with clinical results could help researchers assess whether pollutants are associated with specific cancer types.
Studies would also need to account for other risk factors and differences in exposure across populations.
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India faces a substantial hepatitis C burden, with the World Health Organization (WHO) estimating that 5.5 million to 12 million people are living with chronic hepatitis C virus (HCV) infection.
Untreated chronic HCV infection can lead to liver scarring, cirrhosis and liver cancer. Could shortening treatment by four weeks help more patients access a cure?
A multi-center trial led by researchers from the Indian Council of Medical Research (ICMR) found that an eight-week course of a commonly used antiviral combination was as effective as the standard 12-week regimen in patients without cirrhosis. Published in The Lancet, the findings could have implications for treatment costs and access to care.
The treatment combines sofosbuvir (400 mg) and velpatasvir (100 mg), two direct-acting antivirals that target the hepatitis C virus.
Also read: Punjab To Start Screening For HIV, Hepatitis B & C At De-Addiction Centres
The RESOLVE trial, led by researchers from Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, evaluated whether eight weeks of sofosbuvir and velpatasvir could match the effectiveness of the standard 12-week course.
The trial enrolled 880 patients without cirrhosis across five publicly funded hospitals in Lucknow, New Delhi and Varanasi. Half received the combination for eight weeks, while the other half received it for 12 weeks.
Among participants who completed treatment and follow-up, 98.8% in the eight-week group achieved a sustained virological response, compared with 99% in the 12-week group. This means the virus remained undetectable after treatment, indicating a cure.
The researchers found that the shorter regimen was non-inferior to the standard course, meaning it was not less effective beyond the trial's prespecified statistical margin.
The study also reported no drug-related serious adverse events or treatment discontinuations due to adverse events.
Direct-acting antivirals transformed hepatitis C treatment nearly a decade ago, making it possible to cure most patients with relatively few side effects. However, treatment costs and access remain important considerations for large public health programmes.
A 12-week course of sofosbuvir and velpatasvir costs approximately ₹15,000. Shortening treatment by four weeks could save around ₹5,000 per patient.
If adopted for a population of 60 lakh people requiring treatment, the shorter regimen could potentially save ₹3,000 crore. However, these are projected savings, and the actual impact would depend on patient eligibility, treatment costs and adoption in clinical practice.
The findings apply to patients without cirrhosis, as the trial excluded those with the condition. Patients with cirrhosis may require different treatment approaches depending on the severity of their liver disease and other clinical factors.
The trial's results do not mean that everyone with hepatitis C can switch to an eight-week course. Further evaluation and changes to relevant clinical guidance may be needed before the shorter regimen becomes routine practice.
Patients should consult their treating physician before making any changes to their prescribed treatment.
How Does Hepatitis C Spread?
Hepatitis C can cause illness ranging from mild infection to serious, long-term liver disease. Although some acute infections resolve spontaneously, chronic infection can progress to cirrhosis and hepatocellular carcinoma, a type of liver cancer.
The virus can spread through infected blood, including via shared needles and unscreened blood transfusions.
Perinatal transmission is an important route of HCV acquisition in children. Early detection can help identify infected infants and ensure appropriate follow-up.
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