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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.
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.
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.
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:
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.
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.
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.
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.
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.
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GLP-1 drugs have been become increasingly popular for obesity and type 2 diabetes. But it may also have a beneficial effect on your lungs. New research presented at the European Respiratory Society (ERS) Congress in Barcelona suggests that people with asthma who were prescribed GLP-1 receptor agonists, particularly semaglutide, experienced significantly fewer asthma attacks.
But the important question is - are these drugs directly affecting asthma biology, or are people simply getting their asthma in control because they lose weight?
The study does not provide that answer. In fact, researchers and independent experts say clinical trials are needed before GLP-1 drugs can be considered a treatment for asthma.
Researchers led by Professor Chloe Bloom of Imperial College London’s National Heart & Lung Institute analysed UK electronic health records in four parallel studies.
Each study included around 20,000 to 22,000 people who had started a GLP-1 receptor agonist or a different type of diabetes medicine called a sulfonylurea.
The researchers looked at people with asthma and COPD and compared the frequency of acute respiratory attacks after treatment. The strongest result was seen with semaglutide.
Among people with asthma, semaglutide use was linked with nearly 40% fewer asthma attacks, while among people with COPD, it was linked with about a 20% reduction in flare-ups. The effect appeared stronger among people with more pronounced asthma.
Professor Bloom said, “The effect was strongest with semaglutide especially in people with asthma, where use of semaglutide appears to be associated with nearly 40% reduction in asthma attacks. Semaglutide also led to a 20% reduction in COPD flare ups.”
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Obesity itself is strongly associated with asthma. Excess body fat can affect lungs, increase inflammation and as well as immune response.
Dr. Shehla Shaikh, Consultant Endocrinologist, Saifee Hospital, Mumbai told HealthandMe, “People who are obese have a higher risk of developing asthma and often have asthma that is more frequent or more severe. When people lose weight the pressure, on the lungs decreases breathing becomes easier. Inflammation goes down. That may be why some people who use GLP-1 medicines say they have asthma attacks. However new research suggests that the story may not end with weight loss.”
So, if someone with obesity and asthma takes semaglutide, loses weight and subsequently has fewer attacks, the improvement may simply be a consequence of the weight loss.
Dr Vimal J. Pahuja, Associate Director, Dept of Medicine, Metabolic Physician & Diabetologist, Dr L H Hiranandani Hospital, spoke to HealthandMe, to explain more factors that could influence asthma flare-ups: “Obesity itself can make asthma worse. Extra weight around the chest and abdomen can reduce lung expansion and increase the effort needed to breathe. Obesity is also linked with acid reflux, sleep apnoea and a background state of inflammation, all of which can worsen asthma. Therefore, when a person loses meaningful weight on a GLP-1 drug, it is quite reasonable to expect fewer symptoms and possibly fewer attacks.”
Also read: Wegovy & Zepbound Are Not Approved By US FDA For Children Under 12: So Why Are Prescriptions Rising?
Even though research has not reached there yet, could there be a possibility GLP-1 drugs could have a beneficial impact on asthma? If yes, this could spark hope for the possibility that the drugs could have effects on airway inflammation that are partly independent of weight loss.
Dr. Pahuja explained, “GLP-1 receptors are also found in the lungs. Laboratory studies suggest that activating these receptors may calm inflammatory signals, reduce excess mucus and make the airways less reactive. Animal studies have shown reductions in several immune pathways involved in asthma, including signals that normally attract inflammatory cells into the lungs.”
He continued, “This is scientifically exciting because obesity-related asthma often behaves differently from the typical allergic asthma seen in younger patients. Early human studies are also encouraging. People with both diabetes and asthma who started GLP-1 medicines appeared to have fewer asthma flare-ups than those taking some other diabetes treatments. Importantly, some of this benefit remained even after researchers accounted for weight and blood-sugar changes. However, this does not mean GLP-1 drugs are asthma medicines. They should not replace inhalers or standard asthma treatment.”
The research was observational and based on medical records, rather than a randomised clinical trial. That means researchers observed what happened to people who received different medicines but did not randomly assign the treatments.
Also read: Exclusive: GLP-1 Drugs Are The ‘New Statins’, Says University Hospital Birmingham Professor
Professor Bloom herself cautioned: “The findings from this study are encouraging, but they should not change treatment decisions on their own. People with asthma or COPD should not start GLP-1 receptor agonists specifically for their lung condition outside current prescribing guidance.”
Experts caution that despite promising outcomes of GLP-1 drugs, more research and clinical trials would be needed to prove that weight loss medicines have effects that transcend weight loss and diabetes management.
Dr. Shaikh concluded, “GLP-1 receptors are part of biological pathways that are linked to inflammation and metabolism. Scientists are studying whether GLP-1 drugs could directly affect inflammation in the airways or reactions that help cause asthma. The evidence is still growing, and it is too early to say that GLP-1 drugs really change the underlying biology of asthma.”
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If you regularly drink your tea or coffee “very hot,” you may be at three times higher risk of developing a type of esophageal cancer, according to a new study.
The team found that drinking hot beverages at very high temperatures may increase the risk of esophageal squamous cell carcinoma (SCC), which forms in the mucosal lining of the food pipe.
Studies in Asia, Africa, South America and the Middle East have consistently shown that drinking tea or mate (a herbal drink) at very high temperatures (around 70°C) increases esophageal cancer risk. However, evidence has been limited for drink temperatures typically consumed in Western populations.
To explore this, a team at Oxford analyzed data from around 980,000 UK adults and tracked their health records for more than 10 years to see whether they developed esophageal SCC.
Also read: Why You Suddenly Can’t Tolerate Foods You Once Ate Easily
Compared with people who reported drinking their beverages “warm,” those who preferred their drinks “hot” had nearly twice the risk of esophageal SCC, while those who drank them “very hot” had a three times higher risk.
The findings “add to existing evidence that drinking very hot drinks could increase the risk of esophageal squamous cell carcinoma,” said Dr Keren Papier, lead researcher and senior nutritional epidemiologist at Oxford Population Health.
But does the beverage matter? No, the study did not find that consuming tea and coffee increased the risk of esophageal SCC. Instead, the risk was associated with the temperature of any hot beverage consumed.
“Our findings suggest that reducing drink temperature in populations where tea and coffee are frequently consumed could offer an important means of SCC prevention,” the researchers said.
It is unclear how higher drink temperatures may affect esophageal cancer risk. However, existing evidence suggests that very hot drinks may damage the lining of the esophagus, which, over time, can increase the chance of cancer.
The International Agency for Research on Cancer (IARC) also classifies drinking very hot beverages above 65°C as “probably carcinogenic” to people.
Read More: Attention Ladies: More Than 5 Cups Of Coffee Linked To Lower Bone Density; Tea May Help
The esophagus is a long, hollow tube that helps move swallowed food from the back of the throat to the stomach for digestion. Esophageal cancer is a malignant tumor in the food pipe and primarily affects people over the age of 55.
Lifestyle factors that may predispose a person to esophageal cancer include tobacco use, alcohol consumption, chronic acid reflux, obesity, and poor diet choices.
In the UK, there is a 1% lifetime risk of being diagnosed with esophageal SCC.
While the evidence linking hot drinks to cancer risk is still evolving, there are proven ways to reduce the risk of esophageal SCC.
“The most important ways to reduce the risk of this cancer type are not smoking and cutting down on alcohol,” said Fiona Osgun, head of health information at Cancer Research UK. Letting your tea or coffee to cool down a little before taking a sip, may be a good idea.
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An eclectic approach combines therapeutic frameworks according to an individual's symptoms, personality, developmental history, cultural and socioeconomic context, coping patterns and readiness for change—while keeping the therapeutic relationship and client participation central to recovery.
Psychological difficulties rarely exist in isolation. Anxiety, depression, relationship difficulties or trauma-related symptoms may be influenced by cognitive patterns, emotional regulation, personality, developmental experiences, relationships and social circumstances.
This is why psychotherapy cannot always follow a single therapeutic model. Eclectic therapy allows clinicians to draw from established approaches such as CBT, psychodynamic therapy, trauma-informed interventions, attachment-based approaches, emotion-focused work, mindfulness and behavioural strategies, based on the individual's clinical needs.
Importantly, eclectic therapy is not an arbitrary combination of techniques. Each intervention should have a clinical rationale and be linked to the individual's psychological formulation.
A clinical formulation considers more than symptoms or diagnosis. Personality factors, developmental history, attachment patterns, family dynamics, cultural expectations, socioeconomic circumstances and social identities may all influence how psychological distress develops and is maintained.
For example, the same anxiety symptoms may reflect perfectionism and conditional self-worth in one person, while being associated with attachment insecurity or previous adverse experiences in another.
Therapeutic readiness is also important. A client experiencing significant trauma-related dysregulation may initially require safety, stabilisation, psychoeducation and emotional regulation before deeper trauma processing is appropriate.
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People often arrive in therapy after already trying to manage their difficulties through self-help, lifestyle changes, support from family or friends, boundary-setting or previous therapy.
These efforts should not be dismissed simply because they were unsuccessful. Understanding what the person tried, what helped, what did not and why provides valuable information for case formulation and treatment planning.
Coping mechanisms such as avoidance, perfectionism, emotional suppression or reassurance-seeking may also have served a protective function at an earlier stage. Therapy therefore focuses not merely on labelling a behaviour as maladaptive, but on understanding its function and developing more adaptive alternatives.
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Relationship difficulties: A client who becomes highly distressed by emotional distance in relationships may require a combination of attachment-based psychoeducation, emotion-regulation strategies, cognitive and behavioural interventions, alongside exploration of earlier relational experiences.
Emotional disconnection: A high-functioning client who feels emotionally numb may require less emphasis on problem-solving and greater focus on emotional awareness, intellectualisation, experiential work and exploration of how emotions have historically been managed.
Cultural and social context: Anxiety or depression in a client navigating family expectations, sexuality, gender, financial pressures or minority stress cannot always be understood solely through individual psychological processes. Cognitive, emotional, relational and contextual factors may need to be addressed together.
The therapist provides clinical expertise, psychological formulation, therapeutic skills and appropriate challenge, but the client remains an active participant in the therapeutic process and recovery.
This may involve reflecting on patterns, practising skills between sessions, experimenting with new behaviours and communicating openly about what is or is not working. This responsibility should not be confused with blame; therapy is a collaborative process in which the therapist provides guidance while the client gradually develops greater agency in managing their psychological wellbeing.
The therapeutic relationship remains central. Respect, psychological safety and appropriate therapeutic challenge are particularly important in trauma-informed practice. Respecting a client's history does not mean agreeing with every decision; it means understanding the experiences and circumstances within which those decisions were made.
Eclectic therapy recognises that psychological difficulties are multidimensional and that individuals differ in their personality, history, circumstances, coping mechanisms and capacity for change.
The central clinical question is therefore not simply which therapy works? but which therapeutic approach is most appropriate for this individual, for this difficulty, at this stage of treatment?
When grounded in clinical formulation and evidence-informed practice, eclectic therapy provides flexibility without losing therapeutic structure—allowing treatment to address the person rather than simply the presenting symptom.
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