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.

A sudden twitch in the eyelid can be surprisingly unsettling. For some people, it may happen occasionally and disappear on its own, while for others, repeated twitching can lead to concerns about whether something more serious is going on.

The good news is that an occasional eyelid twitch is usually harmless and self-limiting. Stress is one of the common factors associated with it, but it is not the only one.

What causes an eye to twitch?

Eyelid twitching can often be associated with everyday factors such as stress, lack of sleep, high caffeine intake, smoking and general exhaustion.

For someone going through a stressful period or not getting enough rest, the twitch may appear and become more noticeable. High coffee or caffeine consumption can also be a contributing factor.

In most cases, the twitch settles on its own once the underlying trigger is addressed. It commonly resolves within a few weeks.

This means that an isolated eyelid twitch does not necessarily indicate an underlying eye or neurological disease.

Also read: Andrew Huberman’s Sleep Trick: Can Eye Movements Help You Fall Back Asleep?

Can reducing stress help?

Since stress, tiredness and lifestyle factors can contribute to eyelid twitching, addressing these factors can often help.

Getting adequate sleep, reducing caffeine intake and making time for relaxation can be useful. Meditation and relaxation exercises may also help, particularly when stress appears to be a contributing factor.

The key is to look at the bigger picture rather than immediately assuming that the twitch itself indicates a serious problem.

When should you see an ophthalmologist?

While an occasional twitch is generally not a cause for concern, it is worth consulting an ophthalmologist if the problem continues for several weeks or is accompanied by other symptoms.

Particular attention should be paid if there are:

• Changes in vision
• Swelling of the eyelids
• Difficulty or inability to open the eyes
• Other unusual symptoms accompanying the twitch

Persistent or unusual eyelid movements can sometimes be associated with conditions such as blepharospasm or hemifacial spasm, while certain neurological conditions can also present with symptoms that may initially resemble an ordinary eye twitch.

An ophthalmologist can assess the symptoms and determine whether further evaluation is required.

Also read: The Hidden Health Cost Of Excessive Screen Time: Dry Eyes, Ringing Ears, Poor Sleep

Does an eye twitch mean you have a neurological problem?

This is one of the biggest concerns people have when their eyelid starts twitching.

An isolated eyelid twitch, by itself, is usually not a sign of a serious neurological disease. Instead of focusing only on the twitch, individuals should pay attention to whether there are other neurological symptoms occurring at the same time.

Symptoms such as facial weakness, numbness, difficulty speaking or difficulty walking warrant medical attention and should not be ignored.

The presence of these accompanying symptoms is more significant than an occasional eyelid twitch on its own.

Don't let an occasional twitch cause unnecessary worry

Eyelid twitching can be irritating and, understandably, may cause anxiety. However, in most cases, it is temporary and can settle once contributing factors such as stress, fatigue or excessive caffeine consumption are addressed.

Getting adequate rest, reducing caffeine, managing stress and incorporating relaxation techniques can be simple first steps.

At the same time, persistent twitching or twitching accompanied by changes in vision, eyelid swelling, inability to open the eyes or other neurological symptoms should be evaluated by a medical professional.

The important distinction is between an occasional, isolated twitch and a persistent or unusual pattern accompanied by other symptoms. Knowing that difference can help people avoid unnecessary worry while also recognising when professional evaluation is appropriate.

A surgeon, sitting hundreds of kilometres away, can now operate on a patient undergoing complex procedure by controlling a robotic system. This is no longer just an inexplicable futuristic idea.

India has already seen a major development in robotic telesurgery, as doctors explore whether advanced surgical systems can help connect specialist surgeons with patients in different cities where such expertise may not be accessible.

According to data presented at the Society of Robotic Surgery (SRS) India 2026 conference in New Delhi, the development comes as robotic surgery itself is expanding rapidly across India. Delhi NCR has emerged as the country's leading hub for robotic surgery.

Addressing the SRS India 2026 Conference virtually, Union Minister for Health and Family Welfare Shri J.P. Nadda said "Today India stands at an exciting juncture in the healthcare innovation, with our strength in technology, Artificial Intelligence, digital health and a rapidly expanding ecosystem of surgical robotics, we have opportunity, not nearly to adopt the technology of the future but innovate ,develop and lead. India is increasingly becoming an important global destination for healthcare innovation and advance surgical technology. I congratulate organizers for bringing this important international conference to India."

Delhi NCR Sees Five-Fold Increase In Robotic Surgeries

According to the conference data, 39 hospitals in Delhi NCR now have robotic systems, while 11 hospitals have more than one system. The number of robotic-assisted procedures in the region has also increased from 2,257 in 2021 to 10,937 in 2025. Across India, the growth in robotic surgical procedures increased from 8,912 in 2021 to 44,857 in 2025.

Urology accounted for about 30.2% of robotic procedures in Delhi NCR in 2025, while general surgery-benign procedures made up around 33% and gynaecology 22.1%.

Dr. Vivek Bindal, Organising Chairman, SRS India and Principal Director & Head, Department of Minimal Access, Bariatric & Robotic Surgery, Max Hospital, New Delhi, said, “Delhi NCR has emerged as a leading force in India’s robotic surgery journey, with the highest concentration of robotic-system installations in the country and a rapidly expanding volume of procedures. The presence of robotic systems across 39 hospitals, including 11 hospitals with multiple systems, reflects the depth of expertise and institutional adoption that has developed in the region."

He added, "Delhi has reached this position because of the combined efforts of pioneering surgeons, high-volume hospitals and multidisciplinary teams that have steadily integrated robotic technology into complex surgical care. What we are witnessing is not simply an increase in machines or procedures, but the emergence of Delhi as a centre that is helping shape the future of robotic surgery in India."

Also read: Robotics Set to Transform Every Medical Specialty, From Diagnostics to Therapy in India: Jitendra Singh

India's First Government-Institution Robotic Telesurgery

Prof. Dr. Anup Kumar, Professor & Head, Department of Urology, Robotics & Renal Transplant, VMMC & Safdarjung Hospital, New Delhi, recently performed India's first government-institution robotic telesurgery in urology.

The reconstructive procedure was performed remotely from Gurugram to Preeti Kidney & Urology Hospital in Hyderabad.

The accomplishment has raised the possibility of specialist surgeons operating on patients who are located in smaller cities with limited resources and access.

Also read: 22-Year-Old Woman Undergoes Robotic Heart Surgery After Two Strokes and Months of Delayed Treatment

Scope For Telesurgery

India's major cities have increasingly developed robotic surgery infrastructure and specialist teams. But access to highly specialised surgeons is not evenly distributed across the country. If remote robotic surgery can be safely scaled, a specialist in a major medical centre could operate on a patient in another city through a connected robotic system.

Dr. Anup Kumar said, “India is now at a defining moment in robotic surgery. The rapid rise in robotic procedures—from 8,912 nationally in 2021 to 44,857 in 2025—shows how quickly the technology is being adopted and how clinical expertise is expanding across the country. India is moving beyond being a technology adopter and is developing the experience, infrastructure and surgical capabilities required to become a global force in robotic surgery. If this momentum continues, India has the potential to emerge as a global leader by 2030 and compete with, and potentially surpass, established leaders such as the US. This is a proud moment for Indian healthcare and a significant opportunity to place India at the forefront of the next generation of surgery.”

Robotic telesurgery could also have other advantages besides bridging location gaps. The technology could support remote surgical training, tele-mentoring and collaboration between specialists when needed.

The SRS India 2026 conference also showcased a cross-border robotic telesurgery demonstration between India and China.

Dr. Vivek Bindal led the demonstration, with surgeons at Max Super Speciality Hospital, Vaishali, remotely operating a robotic console nearly 5,000 kilometres away in Chengdu, China during pre-clinical procedures.

How Can This Technology Become Routine?

Remote surgery requires more than a robotic surgical machine and a fast internet connection. The international consensus recommendations published in the World Journal of Surgery in 2026 address issues including connectivity, cybersecurity, surgeon training, credentialing, emergency preparedness and regulation.

There also needs to be a clear plan for what happens if the connection fails or the patient develops an unexpected complication during surgery.

For India, the technology could eventually help narrow the gap between where specialist surgeons are located and where patients live. But for that to happen, telesurgery will need strong infrastructure, trained teams, reliable connectivity and carefully defined safety protocols.

Fatty liver disease has traditionally been associated with obesity and alcohol consumption. However, in clinical practice, we are increasingly seeing fatty liver in individuals who may not appear overweight and who do not consume alcohol. This changing pattern reflects a larger problem: the close relationship between liver health, metabolic health, and lifestyle.

Non-alcoholic fatty liver disease (NAFLD), now increasingly termed metabolic dysfunction-associated steatotic liver disease (MASLD), occurs when excess fat accumulates in the liver in association with metabolic risk factors. A systematic review and meta-analysis of Indian studies estimated the pooled prevalence of NAFLD among adults at 38.6%, meaning that roughly one in three adults may be affected. The prevalence was approximately 28.1% in average-risk populations and increased to 52.8% among individuals with higher metabolic risk.

What is particularly important for Indians is that fatty liver cannot be identified simply by looking at body weight. South Asian populations can develop visceral or abdominal fat and metabolic abnormalities even at relatively lower body mass indices. A South Asian meta-analysis found that NAFLD affected approximately 26.9% of adults in the general population, while prevalence rose to 54.1% among people with metabolic diseases. Importantly, around 43.4% of people with NAFLD in the analysis were not obese.

Diabetes, hypertension, dyslipidaemia, central obesity and metabolic syndrome are therefore important warning signs. In my practice, I often emphasise that a normal-looking body does not necessarily mean a metabolically healthy body. Waist circumference, blood sugar, lipid profile, liver enzymes, and, when indicated, liver imaging provide a much more meaningful risk assessment.

The other misconception is that fatty liver is harmless. Simple steatosis may remain stable in many individuals, but some patients develop inflammation and progressive fibrosis, eventually leading to cirrhosis and liver cancer. A systematic review of hepatocellular carcinoma in India also found that the proportion of cases associated with NAFLD has been increasing, although viral hepatitis remains an important cause. ([PubMed][3])

There is also a broader gastroenterological concern. Digestive and liver health are closely connected with dietary patterns, physical activity, and metabolic health. Excessive intake of refined carbohydrates, sugary beverages, ultra-processed foods, and excessive calories, combined with inadequate physical activity, can contribute to metabolic dysfunction.

The good news is that lifestyle modification can make a substantial difference in fatty liver. Weight reduction, regular physical activity, improved dietary quality, adequate sleep, and better control of diabetes and cholesterol can help reduce liver fat and metabolic risk. Importantly, management should be individualised rather than based on crash diets or unregulated supplements.

Fatty liver should therefore be viewed not merely as an incidental finding on an ultrasound report, but as a metabolic warning signal. Early identification allows us to intervene before irreversible liver damage develops. For patients, the message is simple: taking care of the liver also means taking care of the heart, metabolism, and overall digestive health.

The statistics cited above are based on published systematic reviews/meta-analyses and IARC/WHO data; prevalence estimates vary depending on the population and diagnostic method.

Dr. Pradipta Kr. Sethy, Director Gastroenterology, Manipal Hospitals EM Bypass & Mukundupur