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.

Something as basic as an IV set, syringe, cannula or catheter can make a huge difference in a patient’s essential care and treatment. But a recent FDA survey has raised questions about the affordability of these hospital consumables and whether the lack of transparency in pricing can pose a threat to patient safety.

Maharashtra Food and Drug Administration Commissioner Tukaram Mundhe recently flagged exorbitantly priced hospital consumables and medical devices used in inpatient departments.

The food and drug regulator sought Centre’s intervention to straighten pricing of essential and life-saving medical devices, saying these practices should be ideally “fair, transparent and ethical”.

Maharashtra FDA Chief Tukaram Mundhe Flags Costly Hospital Consumables

The Maharashtra State Price Monitoring Resource Unit, operating under the state FDA, recently conducted the market survey covering medical devices used in inpatient departments, including IV sets, syringes, nebuliser, and oxygen-mask kits, and other consumables.

The survey found that some commonly used medical devices had a gap of up to 2,841% between procurement prices and printed maximum retail prices (MRPs).

For example, an IV infusion set purchased for Rs 11.05 was listed at an MRP of Rs 325. A 10 ml syringe purchased for Rs 6.75 had an MRP of Rs 57.20, while a catheter bought for Rs 29.41 had an MRP of Rs 310.

Maharashtra FDA Commissioner Tukaram Mundhe has sought intervention from the Centre and the National Pharmaceutical Pricing Authority (NPPA), arguing that patients admitted to hospitals are not in the position to bargain over medical products that are essential to their treatment. They may not have the opportunity to compare prices, search for another brand, or simply refuse the product.

In a recent interview, Mundhe said, “A trade margin of 2800 per cent is by any terms not acceptable, either as a consumer or as a hospital or as a regulator.”

Mundhe highlighted this problem in his letter to the Department of Pharmaceuticals, writing, “Because hospitalised patients critically require these non-negotiable surgical consumables during active treatment, they possess zero bargaining power in IPD settings.”

He also described the steep pricing as “completely irrational and unjustified” and argued that the absence of strict statutory price caps for several medical-device categories can leave patients facing large and opaque price differences.

The Centre has now sought a report from the NPPA on the price discrepancies flagged by the Maharashtra FDA.

Also read: Syphilis Among Australian Women Has Risen By 167% In The Last Decade: How It Can Affect Pregnancy & Newborns?

Costly Hospital Consumables May Become A Patient-Safety Issue

World Patient Safety Day is observed on September 17 every year to raise global awareness about the safety of patients and reduce preventable harm in healthcare.

As far as patient safety is concerned, it is not only about whether a device is sterile, functional, or medically appropriate. Affordability and transparency can also influence whether patients are able to access and continue necessary treatment.

A fat hospital bill may cause financial burden, discouraging patients from seeking timely treatment. For families paying out of pocket, unexpected costs can affect decisions about where to seek care, whether to continue treatment or whether to delay non-emergency follow-up.

Mundhe has described the issue directly as a patient-protection concern, saying, “This is not merely a pricing issue; it is a patient-protection issue.”

Also read: Ferritin Face: Can Pale Skin Signal Iron Deficiency?

Industry’s Response To The Maharashtra FDA

The procurement price of a device, however, cannot automatically be treated as the final cost of safely delivering it to a patient.

Hospitals may incur costs related to sterile storage, inventory, staff, emergency availability, wastage, expiry, infrastructure, quality checks, and safe disposal.

Industry representatives have therefore argued that pricing frameworks should distinguish between basic commodity consumables and complex medical technologies.

In a statement, the Association of Healthcare Providers of India (AHPI) said, “Price of device or medicine is very small part of overall cost of administering healthcare, which include manpower (doctors, nurses, paramedical, administration etc.) maintaining infection free environment, infrastructure etc.”

They also reacted to Maharashtra FDA’s pricing concerns and said that hospitals play no part in setting up MRPs of these products.

A new social media trend is prompting people to look more closely at their skin, lips, eyes, hair and nails for possible signs of iron deficiency.

The trend, being referred to as “ferritin face,” centers on an appearance that people describe as looking unusually tired — including dull or dry skin, pale conjunctiva, cracked lips, dark circles under the eyes, and brittle hair and nails.

What Is ‘Ferritin Face’?

“Ferritin face” is not a medical term. Ferritin is a protein that stores and releases iron in the body.

Social media users are increasingly sharing photos of changes in their appearance and linking them to low ferritin or iron deficiency. Some are also encouraging others to get their ferritin levels tested.

“Shout out to the person who commented on one of my videos ... ‘you should get your ferritin levels checked because your lips are very pale,’” one woman said in a TikTok video. “It turns out there’s a reason for why I look so tired and crappy all the time.”

Also read: Bryan Johnson's Autoimmune Gastritis Sheds Light On Iron Deficiency In Americans

Can Iron Deficiency Affect Your Appearance?

Although there is no standard medical definition of “ferritin face,” low iron levels can coincide with visible changes in the face and other parts of the body.

“While the catchy name is a social media invention, the idea that depleted iron can affect how someone looks is medically valid,” Anna Komorowski, division chief of hematology and medical oncology at Northwell's Northern Westchester Hospital in Mount Kisco, New York, was quoted as saying to MedPage Today.

“Importantly, these changes typically occur when deficiency has progressed significantly, not from mildly suboptimal levels.”

Why Iron Deficiency Can Be Missed

Iron deficiency is common, affecting nearly a third of adults in the United States. But it can be difficult to recognize because symptoms may be vague and develop gradually. Iron levels are also not routinely checked.

According to research published in JAMA Network Open, about one in four Americans may have inadequate iron intake or absorption. In the study of more than 8,000 Americans, 14 per cent of adults had absolute iron deficiency, reflecting depleted iron stores.

Even after excluding common causes such as anemia, pregnancy, heart failure and chronic kidney disease, 11 per cent remained iron deficient. Another 15 per cent had functional iron deficiency, where iron levels appear normal but the body cannot use the mineral effectively.

“Because some patients may be iron-deficient without being anemic, they may go on for a very long time without being diagnosed,” Imo Akpan, a hematologist at NewYork-Presbyterian and associate professor of medicine at Columbia University Irving Medical Center, was quoted as saying to the Washington Post.

What Are The Common Signs Of Iron Deficiency?

Iron deficiency can cause a range of symptoms, including:

• Constant tiredness
• Weakness
• Pale skin
• Shortness of breath
• Dizziness
• Headaches
• Hair loss
• Difficulty concentrating
• Frequent infections
• Under-eye circles,
• Cracks at the corners of the mouth,
• Brittle or slower-growing nails
• Exercise intolerance,
• Cold hands and feet,
• Brain fog
• Cravings for non-food items such as ice, soap or chalk.

How Is Iron Deficiency Diagnosed?

Iron deficiency can be assessed with blood tests, including a ferritin test, which measures the body's stored iron. Ferritin levels below 30 nanograms per millilitre can indicate iron deficiency.

How Is Iron Deficiency Managed?

Management depends on the underlying cause and the severity of the deficiency. It can include improving dietary iron intake and taking iron supplements when advised by a healthcare professional.

Iron-rich foods include spinach, beans, lentils, nuts and dates. Vitamin C-rich foods, such as oranges and lemons, can also be included in the diet.

When discussing patient safety in chronic disease management, conversations often focus on drug safety profiles, accurate dosing, and acute complication prevention. In long-term conditions like diabetes, which affects over 100 million people in India, patient safety extends far beyond the medicine. It lies at the intersection of patient education, reliable delivery systems, continuous monitoring, and structured medical guidance.

For instance, the recent evolution in diabetes therapies, such as the shift from 365 daily basal insulin injections a year to just 52 once-weekly administrations, marks a major turning point in chronic care. Reducing injection frequency addresses therapeutic fatigue and needle anxiety, factors that have historically delayed necessary insulin initiation by several years in India. As advanced delivery systems make administration simpler, ensuring that the patient continues long-term treatment is a key requirement for chronic care.

This is where a comprehensive system becomes critical. An advanced delivery device or once-weekly formulation is an enabler. As an intuitive delivery system, it offers accurate dosing and convenience, but cannot interpret fluctuating blood glucose trends, adjust for lifestyle changes, or recognize early warning signs of hypoglycaemia on its own. Long-term patient safety views advanced delivery as an integral link of a broader patient-care framework, which includes:

Also read: Ozempic, Wegovy & PMOS: How GLP-1 Drugs Are Changing PMOS Treatment?

Education as the primary step

Patient safety begins with health literacy. Understanding dose titration, storage conditions, hypoglycaemia protocols, and blood glucose monitoring transforms a patient from a passive recipient into an empowered manager of their health.

Reliability in delivery

Delivery mechanisms, whether daily smart pens or weekly formulations, must deliver predictable, mechanical accuracy. Reliable delivery builds patient confidence, minimizes dosing errors, and alleviates administration anxiety.

Continuous follow-ups

Diabetes is a progressive, dynamic condition. While delivery devices ensure precise administration, continuous engagement with healthcare professionals ensures that treatment regimens adapt to ageing, comorbidities, and lifestyle changes over time. In many cases, technology evolves in response to the pain points shared by the patient.

As the world marks World Patient Safety Day, the focus must expand beyond modernizing treatment delivery to strengthening the entire system surrounding the patient. Innovations in drug delivery are major milestones, but their real-world safety and effectiveness depend entirely on the educational and clinical scaffolding supporting them.

Grounding modern delivery solutions in patient education and clinical continuity creates a model where diabetes care is not only less burdensome, but safe for a lifetime.