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.

Dr Srivanjani Santosh, Pediatrician, Social Activist and First Aid trainer, who had earlier spearheaded the ORS campaigned for eight years, urging FSSAI to ban the misuse of the term 'ORS' on non-WHO=standard sugar drinks, has once again shared an important health video on rabies vaccination. Dr Santosh shared that if any mammal, including dog, cat, horse, cow, buffalo, monkey or bat scratch or bit a person, they must be vaccinated with rabies shot.

She also pointed out something many miss: the location of administering the rabies shot. In her video she urged people to not get the shot administered in buttocks, and to only get it on their shoulders or thighs. She also claimed that many clinics and hospitals, despite knowing this fact, are administering rabies vaccination on buttocks.

Also Read: Hangover Star Ken Jeong's Wife Beats Stage 3 Breast Cancer

Why Does Location Of Administration Matter In Rabies Shot?

The World Health Organization (WHO) strongly recommends that rabies vaccines must be injected into the deltoid region, which is the upper arm or near the shoulder region in adults.

In small children, the WHO notes that deltoid region, as well as anterolateral area of the thigh muscle, which is also the upper thigh works.

WHO notes that like any other injections, rabies vaccine should not be given in the gluteal region, that is the buttocks, because of low absorption due to the presence of adipose or the fat tissue.

This video comes at the time when a case of a Birmingham woman losing all her limbs to dog's lick has made headlines all over the news. Health and Me also reported on the same.

Read: Woman Loses All Her Limbs After Getting Sepsis From Dog Lick

Health and Me spoke to Dr. Rakesh Pandit, Senior Consultant & HOD, Internal Medicine at Aakash Healthcare, who further explained, that as per guidelines by the WHO, the rabies vaccine should not be given in the buttocks as they have a heavy layer of fat. The body might not properly absorb the vaccine if it is injected into this fat instead of the muscle, which could result in a vaccine failure.

"A vaccine failure in case of rabies is like a death sentence because the disease is one hundred percent lethal once it shows the signs. The injection site for the vaccine depends on the patient's age; older children and adults must receive the vaccine in the upper arm or shoulder, while infants and toddlers must receive it in the thigh. The vaccine must also be administered with the right needle length to reach the required depth," he said.

Dr Pandit further elaborated, "The place of administering the vaccine (arm or thigh, subcutaneous or intramuscular) has an effect on the immune response, speed at which the vaccine is absorbed, pain and the risk of side effects." He said, "Some vaccines give best results when given in muscle for better immunity. Other vaccines may need subcutaneous administration. When given at the correct site, the vaccines ensure maximum effect, safety and reduced local reactions like swelling."

Read: 36% Of Rabies Death Comes From India: This Is What You Should Do After A Dog Bite, Explains Doctor

What Should One Keep In Mind While Getting A Rabies Shot?

Dr Mule points out that even when there are minor scratches, without bleeding, you must get a rabies shot. "Rabies can be contracted through broken skin. Such exposures still require medical evaluation and, in most cases, rabies vaccination."

What Should One Do Immediately After Being Bitten Or Scratched?

• Wash the wound immediately for at least 15 minutes with soap and running water
• Apply an antiseptic such as povidone-iodine
• Do not apply home remedies like turmeric, chili or oil
• Seek medical care promptly for rabies vaccination and possible immunoglobin

Dr Mule points out that the rabies vaccine should be started as soon as possible. "Ideally within 24 hours of a bite or scratch. However, even if there is a delay of days or weeks, vaccination should still be started immediately as rabies has a variable incubation period," he says.

The temperature of the vaccine matters. "Rabies vaccines are temperature-sensitive and must be stored between 2°C and 8°C. Exposure to heat or freezing can reduce vaccine potency. Poor cold-chain maintenance is a known reason for vaccine failure in rare cases," points out the doctor.

Dr Mule points out that the vaccine should be given intramuscularly in the deltoid or upper arms for adults, as gluteal or buttock injections could lead to inadequate absorption and reduce effectiveness.

A simple strep throat infection, can trigger sudden skin inflammation, leading to psoriasis, particularly in children and young adults, according to a study.

Researchers from the Karolinska Institutet in Sweden showed that a strep throat infection caused by the Group A Streptococcus (GAS) bacterium, can trigger guttate psoriasis by altering the behavior of key immune cells. Guttate psoriasis is an often sudden-onset form of psoriasis with small, red, "drop-shaped" scaling spots on arms and legs.

While neutrophils -- the most common type of immune cell -- are the first immune cells to respond to GAS infection, the study showed that during a streptococcal infection, the immune cells behavior changes depending on their environment.

Notably, among people with guttate psoriasis, the neutrophils presented with antigens -- fragments of pathogens that signal and guide other immune cells -- get accumulated. Once accumulated, the immune cells activated the T cells, leading to inflammation, explained the researchers in the paper, published in the journal eBioMedicine.

"Doctors have long known that strep throat can precede guttate psoriasis, but the biological explanation has been unclear," said Avinash Padhi, first author of the study and Research Specialist at the Division of Dermatology and Venereology, at Karolinska.

"Our findings suggest a link between infection and skin inflammation through the accumulation of antigen-presenting neutrophils in patients' skin," Padhi added.

How Cells Shape Immune Response

Magdalini Lourda, senior author of the study and senior research specialist at the Department of Laboratory Medicine, noted that the "results challenge the traditional view of neutrophils as simple first-line defenders".

The findings show that the neutrophils play "a wider role in shaping immune responses, which may be important when designing future treatments."

How Was The Study conducted?

To find how neutrophils work in psoriasis, the blood neutrophils from psoriasis patients were compared with those from healthy individuals. Blood neutrophils from patients with severe strep-related lung inflammation were also compared.

What Is Guttate Psoriasis?

Guttate psoriasis is a distinct form of acute-onset psoriasis. It is an inflammatory skin disease characterized by the sudden appearance of red, scaly, and smaller skin lesions widespread over the body.

The condition typically follows an infection, most commonly tonsillitis caused by Group A Streptococcus (GAS). Adolescents and young adults are the most affected. It accounts for about 2 per cent of all cases of psoriasis.

Genetics, environmental triggers, such as an upper respiratory tract infection, and the onset of an inflammatory condition in a distant organ are the major risk factors.

The condition may be diagnosed by skin biopsy, throat swab culture, and blood tests.

Hangover star Ken Jeong's wife Tran Ho Jeong in 2007 discovered a hard lump in her breast while she was breastfeeding their newborn twins Alexa and Zooey. She was diagnosed with stage 3 triple negative breast cancer (TNBC) in 2008.

What Is Stage 3 Triple Negative Breast Cancer?

As per the American Cancer Society, it is an advanced aggressive, and fast-growing cancer that has spread to nearby lymph nodes or tissue, however, does not distant organs. It is characterized by the absence of estrogen, progesterone and HER2 receptors, which requires a combined approach of chemotherapy, surgery, and sometimes also radiations As per the American Cancer Society, TNBC accounts for about 10 to 15 per cent of all breast cancers.

At stage 3, TNBC has grown extensively and invaded nearby tissues and is likely to spread to lymph nodes. However, it has not metastasized to distant organs.

Also Read: Zimbabwe Among the First African Countries to Roll Out Breakthrough HIV Injections

Hangover Star Ken Jeong's Wife Cancer Journey

As doctors said, for Tran, it was a "year of hell". She underwent 16 rounds of chemotherapy when Ken was filming The Hangover. This was then followed by a mastectomy and radiation therapy.

"I am going to survive this. I am going to fight. I have to live for the girls and for Ken," she said. After two years of battle, Tran was finally declared cancer free in 2010. Ken called it "the greatest moment" of his life.

What Happens In Breast Cancer?

As per the World Health Organization (WHO), breast cancer is the most common cancer globally with around 2.3 million new cases every year. At the rate of 1 in every 8 person in both sexes and a quarter of all cancer in women with 70% mortality occurs due to constrained resources.

It is a disease where abnormal breast cells grow out of control and form tumors. If it is left unchecked, the tumors can spread throughout the body and become fatal.

It originates in the milk ducts or the milk-producing lobules of the breast. The earliest form is not life-threatening and can be detected in the early stages. Cancer cells can spread into nearby breast tissue and create tumors that cause lumps or thickening. These invasive cancers can spread to nearby lymph nodes or other organs and metastasis can be life-threatening and fatal.

Signs And Symptoms Of Breast Cancer

The common signs are:

• A breast lump or thickening, often without pain
• Change in size, shape or appearance of breasts
• Dimpling, redness, pitting or other changes in the skin
• Change in nipple appearance or the skin surrounding the nipple (areola)
• Abnormal or bloody fluid from the nipple

Treatment

The treatment depends on the stages and subtypes of the cancer. However, common treatments involve:

• Surgery to remove breast tumor
• Radiation therapy to reduce recurrence of breast cancer around the breast tissues
• Medicals to kill cancer cells and prevent spread
• Therapies like hormonal and chemotherapy or targeted biological therapy