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.

Doctors in Mumbai are reporting a simultaneous rise in Covid-19, H1N1, commonly known as swine flu, and other respiratory viral infections.

As per the doctors, there is up to a 30 per cent surge in cases of COVID-19 and H1N1 as well as viral infections in the city. The doctors attributed the surge in infectious diseases to seasonal changes.

“We are currently observing a 20-30 per cent surge in Covid-19 and H1N1 (swine flu) respiratory viral infections in the city, mainly due to seasonal changes, increased humidity, and exposure to crowded places,” Dr. Aniket Mule, Consultant Internal Medicine, KIMS Hospital Thane, told HealthandMe.

Dr. Amit Saraf, Director of the Department of Internal Medicine, Jupiter Hospital, Thane, reported a rise in influenza-like illness (ILI) in the hospital.

“There is a seasonal rise in respiratory infection cases in Mumbai. Most of the people have routine viral infections, and around 10-15% of the people who are coming to OPDs have been coming positive for influenza-like illness (ILI) due to the changing weather,” Dr. Amit told HealthandMe.

Dr. Rohit Deshpande, Consultant Internal Medicine, Lilavati Hospital and Research Centre in Mumbai, told HealthandMe that the hospital is seeing a rise in swine flu cases.

“On average, 7 to 8 cases are being detected in the OPD daily. Most patients present with symptoms such as fever, cough, body ache, and fatigue”.

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What Are The Symptoms?

The experts reported that the commonly seen symptoms include:

• persistent fever,
• dry or wet cough,
• sore throat,
• fatigue,
• body ache
• mild breathlessness

Who Is More Vulnerable?

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Dr. Amit noted that people with chronic illnesses, elderly people, pregnant women and young children are still more susceptible to complications.

Dr. Rohit noted that people with diabetes and those with conditions such as COPD, asthma and heart diseases are also at higher risk of infection.

How To Prevent?

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The experts noted that most of the cases now are mild and can be handled with timely consultation, rest and supporting care.

But older people, pregnant women, children, and those with pre-existing health conditions should take extra care. Those with an ongoing fever, cough, sore throat, breathlessness, or extreme tiredness should seek immediate medical advice, Dr. Aniket said.

“Simple preventive measures like hand hygiene, use of masks in crowded places, proper hydration and timely medical consultation can help a lot in reducing the risk of complications,” he told HealthandMe.

Preventive measures for the general population include:

• Avoid self-medication
• If you experience a persistent cough or breathing difficulties, consult a doctor regarding the need for anti-viral or anti-allergy medications.
• Get vaccinated every year to boost Immunity and reduce the risk of infection.
• Avoid crowded and dusty places, redevelopment areas, or places with pigeon droppings.
• Use hand sanitizer, wash your hands frequently and thoroughly, and wear a mask in crowded or dusty environments
• Do warm saline gargles with salt or betadine twice or thrice a day
• Take steam hydration if required too
• Maintain hydration to avoid weakness, fatigue, or headache
• To boost immunity - consume green leafy vegetables & Vitamin C-rich fruits along with Vitamin D supplements

The common perception about varicose veins is that they are merely an aesthetic or cosmetic problem. Varicose veins are indeed enlarged, twisted blood vessels that many people believe are not life-threatening. But the reality is that the condition may be a symptom of something more serious.

The disease manifests itself through insufficient blood supply in the body caused by faulty valves. As the blood vessels cannot effectively move the blood from the veins back to the heart, the blood tends to accumulate in the veins themselves. Other symptoms may include pain, heaviness, swelling, and skin sores in severe cases.

What Are The Causes Of Varicose Veins?

Varicose veins don’t develop overnight; they are usually the result of multiple underlying factors that gradually affect vein health and blood flow:

1. Valve dysfunction and poor circulation: Healthy veins rely on tiny valves to prevent backflow. When these valves weaken, blood starts collecting in the veins, leading to increased pressure and visible swelling.

2. Prolonged standing or sitting: These days, occupations require long hours of standing, which can hinder proper blood circulation and increase the risk.

3. Hormonal changes: Hormonal fluctuations during pregnancy, menopause, or while using hormonal therapies can relax vein walls, making them more prone to dysfunction.

4. Genetics: A family history of varicose veins significantly raises the likelihood of developing them, indicating a hereditary component in vein wall strength and valve efficiency.

5. Obesity and lack of physical activity: Excess body weight puts additional pressure on veins, while a sedentary lifestyle reduces the efficiency of blood circulation, leading to vein damage over time.

6. Ageing: As people age, veins lose elasticity, and valves may wear out, making older adults more susceptible to developing varicose veins.

What Are The Tips To Take Care Of?

People can manage or reverse varicose veins by:

• Making sure blood is circulating well in the body: An inactive lifestyle or standing for long periods can lead to increased risks of vein disease. Exercise and movement, along with raising the legs, will ensure that blood continues circulating well.

• Maintaining a healthy weight: Obesity can lead to increased pressure on the veins of the legs. Maintaining a healthy body weight is important to avoid and treat varicose veins.

• Wear compression stockings: Compression stockings apply gentle pressure to the veins, which enables them to circulate blood effectively and avoid swelling and other conditions.

• See a vein specialist if necessary: In cases of persistent pain, discoloration of skin, severe itching, or sores that don't heal, it is advised to see a vein specialist, as these symptoms could signal something worse.

How Can It Be Treated?

Varicose vein treatment procedures have become much easier in the modern world. Varicose veins can now be treated with minimally invasive procedures that address the problem at its root cause. These minimally invasive treatments include EVLT (Endovenous Laser Treatment), Radiofrequency Ablation (RFA), and glue ablation. A laser fibre is inserted into the varicose vein during this operation, where it effectively closes it off.

Blood is automatically redirected through other veins after this treatment, which is relatively quick and involves local anesthesia. Patients generally recover within one day. However, EVLT is much less painful, safer, and does not involve leaving scars behind.

Varicose veins are often a symptom of vein disease and thus not just a cosmetic problem. They can be a visible sign of an underlying circulatory issue. Paying attention to early symptoms and seeking medical advice can help prevent complications and improve overall vascular health. Preventing further problems is easy when one knows what to do.

Knee problems were once considered an issue associated with old age. However, an increasing number of Indians in their 30s are experiencing knee pain, stiffness, and cartilage damage similar to arthritis. Doctors are reporting more cases of young adults seeking treatment for knee-related issues that can affect mobility and quality of life.

Sedentary Lifestyle And Lack of Physical Activity

One of the biggest reasons behind early knee damage is a sedentary lifestyle. Many young professionals spend long hours sitting at desks, working on computers, or using mobile devices. Lack of regular movement weakens the muscles around the knees, reducing the support they provide to the joint.

At the same time, some individuals suddenly engage in intense workouts without proper conditioning. This puts excessive stress on the knees, increasing the risk of injuries and long-term wear and tear. Maintaining a balanced exercise routine with strength training and stretching can help protect knee health.

Rising Obesity And Excess Weight

India has witnessed a rise in obesity among young adults. Excess body weight places additional pressure on the knee joints, which are responsible for supporting most of the body’s weight. Even a small increase in weight can significantly increase stress on the knees during activities such as walking, climbing stairs, or running.

Over time, this extra pressure can lead to cartilage deterioration, inflammation, and chronic pain. Maintaining a healthy weight through proper nutrition and regular exercise can reduce the risk of developing arthritis-like symptoms at an early age.

Poor Posture And Nutritional Deficiencies

Poor posture while sitting, standing, or exercising can also contribute to knee problems. Improper movement patterns may cause uneven stress on the joints, leading to gradual damage. Additionally, untreated sports injuries or ligament tears can accelerate knee degeneration if not managed properly.

Nutritional deficiencies, particularly low levels of vitamin D and calcium, are another concern. These nutrients play a vital role in maintaining strong bones and joint health. Deficiencies can weaken the musculoskeletal system and make individuals more susceptible to knee-related issues.

Steps to Protect Knee Health

Preventing early knee damage requires a combination of healthy habits. Individuals should engage in regular low-impact exercises such as walking, swimming, or cycling to strengthen the muscles around the knee. Maintaining a healthy body weight can significantly reduce pressure on the joints.

It is also important to follow an ergonomic posture while working, take frequent breaks from prolonged sitting, and avoid sudden high-intensity workouts without proper preparation. A balanced diet rich in calcium, vitamin D, protein, and anti-inflammatory foods can support bone and joint health. Most importantly, persistent knee pain should not be ignored, and timely consultation with a healthcare professional can prevent minor issues from becoming serious conditions.

Conclusion

The growing incidence of arthritis-like knee damage among Indians in their 30s is a result of multiple lifestyle factors, including inactivity, obesity, poor posture, injuries, and nutritional deficiencies. While the problem is becoming more common, it is largely preventable. Regular exercise, maintaining a healthy weight, following a balanced diet, and seeking timely medical attention can help preserve knee health and reduce the risk of long-term joint damage.

(By Dr. Sanjeev Kapoor, Senior Consultant, Rheumatology, ISIC Multi-Speciality Hospital)