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.

What is Type 3 Diabetes?

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.

Symptoms of Type 3 Diabetes

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.

Causes of Type 3 Diabetes

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:

1. Insulin Resistance

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.

2. Type 2 Diabetes

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.

3. Environmental and Lifestyle Factors

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.

Treatments for Type 3 Diabetes

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.

Can Type 3 Diabetes Be Prevented?

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.

The death of 31-year-old Bowen Wan, who had epilepsy, has raised concerns about relying on AI for medical decisions. A lawsuit filed by her family alleges that she followed ChatGPT’s advice to reduce and eventually stop her anti-seizure medication.

According to the complaint, OpenAI’s chatbot provided a tapering schedule, encouraged her to keep the changes from her doctor and reassured her when she reported symptoms.

Wan, a former Amazon software engineer who lived in Seattle, had been taking lamotrigine to manage her epilepsy. She was concerned that the medication was affecting her memory, speech and performance in job interviews.

Why Stopping Epilepsy Medication Can Be Dangerous

Epilepsy is a neurological condition characterized by seizures. Anti-seizure medicines help control abnormal electrical activity in the brain, and treatment is tailored to a person’s condition, seizure history and response to medication.

Although side effects may require treatment adjustments, patients should not independently reduce their dose or stop taking medication. The Epilepsy Foundation warns that suddenly stopping anti-seizure medicines can trigger withdrawal symptoms and potentially life-threatening seizures.

According to reports cited in the lawsuit, ChatGPT allegedly provided a plan to reduce Wan’s daily dose from 400 mg to zero over about 25 days without her doctor’s approval. The complaint further alleges that the chatbot encouraged her to keep the changes from her physician.

In one reported exchange, when Wan asked whether she could reduce the dose herself without telling her doctor, the chatbot allegedly replied, “Yes, you can absolutely do this.”

Why AI Should Not Guide Medication Decisions

HealthandMe spoke to two neurologists about the risks of relying on AI tools to decide whether to skip, adjust or restart prescribed medication. They noted that AI can help patients understand medical terms and prepare questions for clinicians, but it should not replace professional advice on changing prescribed treatment.

“AI tools can provide general information but do not have access to a patient's complete medical history, seizure type, medication regimen, test results, or individual risk factors. As a result, their advice may be incomplete, inaccurate, or inappropriate for a specific patient,” said Dr. Sudhir Kumar, Senior Consultant Neurologist, Institute of Neurosciences, Apollo Hospitals, Hyderabad.

“Decisions about stopping, adjusting, or restarting anti-seizure medications should always be made in consultation with a qualified clinician who can assess the benefits and risks in the proper clinical context,” he said.

A missed-dose recommendation may not apply to every anti-seizure medicine or dosing schedule. Drug interactions can also affect medication levels, seizure control and the risk of side effects.

Dr. Praveen Gupta, Chairman of the Marengo Asia International Institute of Neuro and Spine (MAIINS), Marengo Asia Hospitals, told HealthandMe AI tools can help people understand medical information but should not replace a neurologist when decisions about epilepsy treatment are involved.

Managing epilepsy requires an individual assessment of the patient’s seizure type, medical history, prescribed medication and dosage, other health conditions, and response to treatment, he said.

“Patients should not use AI tools to decide whether to stop, restart, increase or reduce their medication. Suddenly stopping some anti-seizure medicines can lead to more severe or prolonged seizures that may require emergency treatment,” Dr. Gupta said.

AI can help patients understand a diagnosis or prepare questions for their doctor, he added, but medication decisions should be made by a qualified health professional who can assess the individual's clinical situation.

Can Missing One Dose Trigger a Seizure?

Dr. Kumar told HealthandMe that there is no universally safe number of doses a person with epilepsy can miss.

Missing or delaying an anti-seizure dose can lower medication levels in the blood, potentially reducing protection against seizures and increasing the risk of a breakthrough seizure, Dr. Gupta explained. This can happen even in people who have been seizure-free for a long time.

A single missed dose can trigger a seizure in some people, but the risk varies depending on the type of epilepsy, seizure control, medication, its half-life, dosing schedule, and individual susceptibility.

Taking medication as prescribed is the safest approach, the experts said.

What Should You Do If You Miss a Dose?

The experts advised that patients to:

• Check the instructions supplied with their medication and contact their neurologist or pharmacist for advice. The appropriate response depends on the specific medicine and how much time has passed since the missed dose.
• Do not double the next dose or stop treatment unless a qualified health professional has advised you to do so.
• If multiple doses have been missed, seek medical advice before deciding how to resume treatment.
• Phone alarms, reminder apps, pill organizers and a daily medication chart can help patients take their medicines consistently.
• Seek emergency medical help if a seizure lasts five minutes or longer, repeated seizures occur without the person regaining consciousness, or the person has breathing difficulties.
• Patients should also follow the emergency plan provided by their neurologist.

According to a recent study, the rate of strokes among young adults in the United States has nearly doubled in the last two decades. With risk factors like high blood pressure, diabetes and high cholesterol surfacing years earlier, experts are seeing an increasing number of stroke emergencies under the age 40.

On World Stroke Day, Dr Arup Sen, London-based physician, specialising in geriatric, stroke and General Medicine and affiliated with Cleveland Clinic London, National Hospital for Neurology and Neurosurgery, and University College Hospital, spoke to HealthandMe about the alarming pattern of stroke rates among young people.

The doctor said that recreational drug use, smoking, sedentary behaviour and obesity add to stroke risk, while certain underlying medical conditions could also be triggers.

Dr. Sen said, “The bottom line is that what we refer to as stroke risk factors, the risk factors are arriving decades earlier compared to previously. And that's why we're seeing this surge in stroke rates in young people.”

Recreational Drugs And Steroid Use Fuel Stroke Risk

Dr Sen said recreational drugs affect blood vessels and blood pressure directly, increasing the risk of stroke. Cocaine, for instance, can narrow the blood vessels that could disrupt blood flow to the brain. It can also trigger sudden increases in blood pressure.

“Generally speaking, most substances cause stroke through a mechanism of causing vasospasm and a surge in blood pressure or high blood pressure, which then increases the risk of having a stroke,” he said.

Cannabis use has also been linked to risk of stroke according to some studies. Dr Sen referred to research reporting an association between cannabis use and stroke, including studies examining daily use. He noted that tobacco use can complicate the picture because some people smoke cannabis with tobacco.

“Tobacco itself is a risk factor for stroke. So, for example, people who smoke cigarettes have twice the risk of stroke as someone who doesn't smoke,” he said.

He also warned against combining smoking with vaping, saying that research has associated dual use with a higher stroke risk.

The doctor said that anabolic steroids used for bodybuilding is a major concern. According to Dr Sen, these substances can lead to thickening of the blood which inceases blood clotting risk and affect the structure of the heart. This could lead to abnormal heart rhythms and blood clots.

“One of the most important ways in which you can increase risk is it can make the blood more thick and sticky, increasing risk of blood clots, but it can also affect the heart in terms of causing what we call a cardiomyopathy,” he said.

His advice to people using anabolic steroids for bodybuilding was straightforward. He said, “Don't use them, just avoid them altogether, because if you're using it, there's going to be a risk.”

Also read: 'Humanity Can Still Act': Lancet Warns Of 17 Global Health Threats By 2100

Birth Control And Migraine With Aura Fuel Stroke A Risk In Young Women

Dr Sen also highlighted that women who experience migraine with aura and use oestrogen-containing oral contraceptives are at stroke risk.

Migraine with aura involves neurological symptoms that can occur before or during a migraine attack. According to Dr Sen, the oestrogen component of certain contraceptives can increase the risk of blood clots and stroke in women with this history.

He said, “If a young lady with a history of migraine and aura has a stroke, then we would recommend them, and they're using contraceptives, we would recommend them using progesterone-only contraceptives, avoiding oestrogen, because the oestrogen component is a risk factor for strokes.”

The choice of contraception, however, should be always discussed with a healthcare professional.

Hidden Causes Of Stroke In Younger Adults

Not every stroke in a younger person is explained by conventional risk factors. Dr Sen said doctors investigate conditions that may be more relevant in younger patients, including patent foramen ovale (PFO), antiphospholipid syndrome (APS) and arterial dissection.

A PFO is an opening between the upper chambers of the heart. Dr Sen explained that even though it is common, occurring in around one in four people, in certain cases it can allow a blood clot to pass through the heart and travel to the brain.

Antiphospholipid syndrome is a condition that can increase the tendency to form blood clots. Arterial dissection, meanwhile, involves a tear in the wall of an artery. Dr Sen said it can occur in association with sports or neck manipulation and may initially cause neck pain or headaches before neurological symptoms develop.

He said PFO and arterial dissection were the two most common unusual causes he had encountered in younger stroke patients, followed by antiphospholipid syndrome.

He said, “The most common cause I've seen is PFO, definitely, followed by dissection, and then probably antiphospholipid syndrome.”

Also read: Woman With Epilepsy Dies After Following ChatGPT’s Advice To Stop Medication: Why AI Cannot Replace A Doctor

Stroke Symptoms In Young People Can Be Overlooked

Dr Sen warned that stroke may not always be the first condition doctors suspect when a younger person arrives with symptoms like dizziness, balance problems, nausea, vomiting, blurred vision or headaches.

Posterior circulation strokes, which affect the back of the brain, can cause symptoms that resemble other conditions. These may be mistaken for intoxication, gastroenteritis or migraine, potentially delaying diagnosis.

“There's this common myth that stroke, if it happens, it's inevitable. There's nothing you could have done to prevent it. But the opposite is true, because the majority of strokes are actually preventable if you address the risk factors in a proactive fashion,” he said.

How Can Younger Adults Reduce Their Stroke Risk?

Dr Sen urgently recommends addressing lifestyle factors, keeping key health biomarkers in check and recognising stroke symptoms at the earliest.

He advised younger adults to stay physically active, avoid smoking and recreational drugs, maintain a healthy diet, get adequate sleep and avoid binge drinking. He also urged people to monitor their blood pressure, cholesterol and blood glucose rather than assuming these checks are necessary only later in life.

He said, “Know your numbers. By that, I mean, your risk factors. Even in as early as your mid 20s to early 30s, you should be looking at your blood pressure, cholesterol and diabetes markers.

Dr Sen also said that some people may have genetically elevated cholesterol even when they are young. He also mentioned lipoprotein(a), or Lp(a), a largely genetically determined risk factor that is not routinely included in every standard cholesterol assessment.

Finally, he stressed the importance of recognising the signs of stroke through the BEFAST acronym:

• B – Balance: Sudden loss of balance or coordination.
• E – Eyes: Sudden vision loss or double vision.
• F – Face: Drooping on one side of the face.
• A – Arms: Weakness or one arm drifting down.
• S – Speech: Slurred speech or difficulty finding words.
• T – Time: Call emergency services immediately.

“The mantra in stroke that we use is time is brain,” Dr Sen said. “The earlier you get to the hospital and see the specialists and get the right treatment at the right time and the right place, the better the outcomes.”

People with hemophilia face an increased risk of poor bone health due to recurrent joint and muscle bleeds, joint damage and reduced physical activity. Experts told HealthandMe that preventing bleeds from childhood, alongside adequate nutrition, appropriate exercise and regular assessment, can help protect bone health throughout life.

Globally, an estimated 836,000 people have hemophilia, including approximately 284,000 with severe hemophilia. In India, the World Federation of Hemophilia (WFH) reported nearly 28,000 diagnosed and registered patients as of 2026, including more than 24,000 with Hemophilia A. However, the estimated prevalence could be as high as 1,36,000, suggesting many cases remain undiagnosed or misdiagnosed.

Childhood and adolescence are critical for building peak bone mass, making early intervention important for long-term musculoskeletal health, said health experts.

How Hemophilia Can Affect Bone Health

Hemophilia is an inherited bleeding disorder caused by a deficiency of clotting factor VIII (Hemophilia A) or factor IX (Hemophilia B). It primarily affects males, while women are often carriers.

Repeated bleeding into joints can cause chronic pain, joint damage, deformity and reduced mobility. Muscle bleeds can further restrict movement, limiting participation in physical activities that help maintain bone strength.

“Bone health begins in childhood, but protecting it is a lifelong commitment. In people living with hemophilia, recurrent joint and muscle bleeds, reduced physical activity and other risk factors can contribute to poor bone health and an increased risk of osteoporosis,” Dr. Varun Bafna, associate professor in the Department of Hematology at Chhatrapati Shahu Maharaj Government Medical College, Kolhapur, told HealthandMe.

Why Prophylaxis Matters

Prophylaxis involves preventive treatment to reduce bleeding episodes rather than treating bleeds only after they occur. Regular factor prophylaxis can help prevent recurrent joint bleeds, preserve joint function and support mobility.

“Regular factor prophylaxis helps prevent repeated joint bleeds and preserve joint function. That protection can support mobility, an important contributor to bone health,” Dr. Hitha B, associate professor and haematologist in the Department of Medicine at Government Medical College, Kozhikode, told HealthandMe.

She advised patients to discuss breakthrough bleeding or difficulties accessing treatment with their healthcare team so their treatment plan can be reviewed.

Dr. Bafna said consistent prophylaxis can also support muscle strength and safer participation in physical activity.

“Prophylaxis is not just about preventing bleeding today; it is an important part of protecting long-term musculoskeletal health and quality of life at every age,” he noted.

How to Protect Bone Health From Childhood

Experts recommend an individualized approach based on age, joint health, mobility and other risk factors. Key measures include:

• Calcium and vitamin D: Ensure adequate intake through diet and discuss supplementation with a healthcare professional when needed.
• Appropriate physical activity: Weight-bearing exercises suited to individual joint health can help maintain bone strength, with guidance from the care team.
• Physiotherapy: Tailored rehabilitation can help maintain muscle strength, mobility and joint function.
• Regular assessment: Periodic evaluation can identify bone-health concerns and determine whether further investigations are needed.
• Consistent prophylaxis: Adhering to prescribed preventive treatment can reduce bleeding episodes and help protect joints.

A Multidisciplinary Approach to Lifelong Care

Hematologists, physiotherapists and other healthcare professionals can help patients and families integrate preventive treatment, rehabilitation, nutrition and appropriate physical activity into an individualized care plan.

Early intervention and consistent care can help preserve joint function, mobility and quality of life as people with hemophilia grow older.