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.

Obesity drugs such as semaglutide and tirzepatide may offer benefits beyond weight loss and blood sugar control. Researchers say these medicines could also help protect brain function, including memory and other cognitive abilities.

Researchers from the University of Gothenburg and the University of Copenhagen examined evidence on how these drugs affect the brain and their potential to inform treatments aimed at preserving cognitive function. The review was published in the journal Science.

How Do Obesity Drugs Affect The Brain?

Semaglutide and tirzepatide belong to a class of medicines that act on metabolic pathways involved in appetite and blood sugar regulation. They may also influence biological processes important for brain function.

Animal studies suggest that GLP-1 drugs can affect learning and memory. However, findings from human studies have been mixed.

Studies analysing patient records have linked GLP-1 treatment to a lower risk of dementia among people with type 2 diabetes. However, these findings do not establish whether the medicines themselves are responsible for the reduced risk.

Semaglutide Failed To Slow Alzheimer's Progression

The potential benefits of these drugs have also been examined in people with Alzheimer's disease.

In Novo Nordisk's EVOKE and EVOKE+ clinical trials, semaglutide did not slow disease progression in patients with early Alzheimer's disease, despite producing changes in several biological markers associated with the condition.

However, researchers say these findings do not rule out potential benefits in other groups of patients.

People with obesity or type 2 diabetes may experience difficulties with attention, planning and processing speed. These cognitive problems are often associated with metabolic and vascular health, making them potential targets for treatment.

Stina Börchers, first author of the review and a researcher affiliated with the University of Gothenburg and the University of Copenhagen, said it is important to establish whether these treatments can help preserve cognitive abilities, particularly when started before problems become established.

“We need to find out whether these treatments can help people with obesity or diabetes preserve their cognitive abilities, particularly if treatment begins before cognitive problems become established,” Börchers said.

Could Obesity Drugs Lead To New Brain Treatments?

Researchers are trying to understand whether the potential effects of obesity medicines on the brain result from improved metabolism, direct action on the brain, or a combination of both.

Christoffer Clemmensen, senior author of the review and research group leader at the University of Copenhagen, said advances in obesity medicines offer new opportunities to understand how metabolic regulation influences brain function.

“By disentangling the direct and indirect effects of these drugs on the brain, we may ultimately be able to develop treatments specifically aimed at preserving cognitive function,” Clemmensen said.

Why More Clinical Trials Are Needed

The researchers are calling for clinical trials that assess memory and other cognitive abilities from the beginning of treatment.

They also stress the need to monitor older and frail patients. Rapid weight loss and loss of muscle mass could affect physical function and potentially reduce the benefits of treatment in these groups.

For now, whether obesity drugs can help preserve cognitive function remains an important research question. More clinical evidence is needed before they can be considered treatments for protecting brain health.

For 25-year-old Kaela Knight, a nail artist from Colorado, taking tirzepatide, the active ingredient in Eli Lilly's Mounjaro and Zepbound, brought an unusual side effect: skin so sensitive that even a light touch hurt.

Knight started treatment in September 2024 at 210 pounds and eventually reached 125 pounds. But during her second month, as her dose increased from 2.5 mg to 5 mg, she began experiencing burning sensations.

"I always describe it as feeling like a sunburn without any visible redness or irritation," she told the Daily Mail.

The sensation affected her hips, forearms and neck. Episodes lasted 24–48 hours, although some persisted for about a week.

Other patients taking Novo Nordisk's Ozempic and also Mounjaro have reported similar experiences.

Known as allodynia, this nerve-pain condition makes normally harmless sensations, such as clothing brushing against the skin or a light touch, painful. Patients describe it as a sunburn without visible redness or irritation.

Although it is not an established side effect of Ozempic, Wegovy, Mounjaro or Zepbound, medical reports have documented similar symptoms. A direct link remains unproven.

"I have [areas] all over that are burning. It's driving me nuts," one Reddit user wrote. Another said painkillers and lidocaine gels offered little relief.

Some patients report improvement after reducing their dose or stopping treatment.

Also read: Ozempic Hair: GLP-1 Drug Use Linked To 7% Higher Baldness Risk In Men

Why Could Weight-Loss Injections Cause Burning Skin?

Semaglutide, used in Ozempic and Wegovy, mimics the GLP-1 hormone. Tirzepatide, used in Mounjaro and Zepbound, targets GLP-1 and GIP receptors.

Dr Richard Siegel, an endocrinologist at Tufts Medicine, told the Daily Mail that these drugs could potentially affect nerve signalling through the brain and spinal cord.

Another theory involves changes in the fat layer beneath the skin during weight loss, which could affect nerve sensitivity. Neither explanation has been proven.

What Do Medical Reports Reveal?

An October 2025 report documented two cases:

• A 56-year-old woman developed painful skin sensations after switching to semaglutide 2.4 mg. Symptoms resolved without treatment after six weeks.
• A 75-year-old man with type 2 diabetes developed widespread burning after switching to tirzepatide. Symptoms resolved after he discontinued it and returned to oral semaglutide.

Some patients report improvement over time or after reducing their dose.

Dr Siegel said symptoms can last days to weeks, potentially becoming less noticeable as the body adjusts to treatment, much like nausea and constipation.

"It's possible something similar is happening here, where temporary changes in receptor activity alter nerve signaling at first, but become less noticeable as the body adjusts," he said.

Read More: Stopping Ozempic, Wegovy, Mounjaro Linked To 22% Higher Heart Attack, Stroke Risk: Study

Newer Weight-Loss Drugs May Carry A Higher Risk

Clinical trials have also recorded dysesthesia, a broader category of abnormal sensations, including burning and tingling. It is not necessarily the same as allodynia.

In a high-dose oral semaglutide trial, dysesthesia occurred in fewer than 3% of 334 participants, compared with none receiving placebo.

Phase 3 trials of retatrutide, an experimental drug targeting GLP-1, GIP and glucagon receptors, reported:

• 9 mg dose: 8.8%
• 12 mg dose: 20.9%
• Placebo: 0.7%

Who Is More Vulnerable To Allodynia?

Risk factors remain unclear. Dr Siegel believes higher doses could play a role.

"As best as I can tell, it would mostly be people on higher doses of these medications," he said.

He also suggested that people with greater pain sensitivity, including those with fibromyalgia, might be more susceptible.

What Should Patients Do?

Patients experiencing unusual skin burning or sensitivity should consult their doctor. Dose adjustments or alternative treatments may be considered, but medication should not be changed or stopped without medical advice.

Allodynia can also occur with shingles, migraines and nerve damage, so symptoms should not automatically be attributed to weight-loss drugs.

Dr Siegel recommends recording when symptoms occur, where they appear and what makes them better or worse.

Persistent or worsening pain should be medically evaluated.

When was the last time you took the stairs without thinking twice, walked to the market without needing a break, or said yes to an outing without worrying about how tiring it might be?

Sometimes, the first sign that something has changed with your health is not a new symptom, but an activity you have quietly given up. A morning walk gets shorter, a flight of stairs calls for a pause, or a favourite weekend outing starts to feel like too much effort. It is easy to put these changes down to age, but they may be telling you something worth investigating.

A simple “activity audit” can help you connect the dots. Instead of asking only whether you feel unwell, compare what you could comfortably do a few years ago with what you can manage today.

Could you walk the same distance without stopping? Have stairs that once felt routine become difficult? Have you cut back on morning walks, stopped playing a favourite sport or become less inclined to leave the house? Do everyday activities such as grocery shopping, gardening or household chores require more effort than before?

These questions are particularly relevant after age 45, when declining stamina may be attributed entirely to ageing. However, a persistent change in exercise tolerance or everyday activity should not automatically be dismissed as a normal consequence of ageing.

Breathlessness during activity, unusual fatigue, dizziness or light-headedness, swelling in the feet or ankles, and palpitations can occur in people with heart valve disease. These symptoms can also have other causes, but if they are persistent, unexplained or worsening, they warrant discussion with a healthcare professional.

Heart valve disease can develop gradually, allowing people to adapt their routines without recognising the underlying problem. Someone who becomes breathless while walking may take shorter routes, while another person may avoid stairs or social activities that involve physical exertion. Eventually, these adjustments can become part of daily life, making it harder to recognise a change in health.

Looking back can help restore that perspective. A simple three-part comparison offers a useful starting point: What could I do before? What can I do now? What changed in between?

Family members can also help identify differences that an older relative may have overlooked. A parent who once travelled regularly may begin avoiding trips, while someone who enjoyed gardening, shopping or meeting friends may increasingly prefer to stay home. These observations cannot establish a diagnosis, but they can prompt a timely conversation about health.

If breathlessness, fatigue, dizziness, swelling, or palpitations are new, persistent, or interfering with everyday activities, consulting a doctor can help determine the cause. Depending on the symptoms and medical history, the evaluation may include a physical examination and an echocardiogram, commonly called a 2D echo. This ultrasound test helps assess the heart's structure and how its valves function.

An activity audit is not a diagnostic test. Its purpose is to help people recognise changes that might otherwise go unnoticed and decide when to seek medical advice.

Growing older does not necessarily mean giving up the activities that make everyday life enjoyable. Paying attention to changes in physical ability can help distinguish an expected adjustment from a potential health concern.

Start your activity audit today. Think about three activities you could comfortably do a few years ago but now find difficult, tiring or have stopped altogether. Note when these changes began and whether you have experienced symptoms such as breathlessness, unusual fatigue, dizziness or palpitations. If you notice a persistent or unexplained decline, schedule a consultation with your doctor and discuss whether further evaluation, including an echocardiogram, may be appropriate.

The question is simple: What have you stopped doing, and could your health be the reason? Taking that first step can help you understand the change and decide what to do next.

(By Dr. Sumanto Mukhopadhyay, a Senior Consultant Interventional and Structural Cardiologist, Apollo Hospital, Kolkata)