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.

The National Medical Commission (NMC) has issued an advisory mandating strict adherence to safe injection practices. The directive aims to curb preventable outbreaks of HIV, Hepatitis B (HBV), and Hepatitis C (HCV) caused by the unsafe reuse of syringes, needles, and other single-use medical devices.

Despite decades of evidence and repeated warnings from the World Health Organization (WHO), unsafe injection practices continue in India, often under the guise of cost-saving. This has led to avoidable infections, lifelong treatment costs, and a loss of public trust in healthcare systems.

What the NMC Advisory Says

The advisory mandates:

• Single-use devices must never be reused:Reuse of syringes, dialyzers, or vials is a direct breach of patient safety.
• Progressive adoption of safety-engineered auto-disable syringes: These devices prevent reuse and help protect healthcare workers from needle-stick injuries.
• Strict enforcement of the Biomedical Waste Management Rules, 2016: Proper segregation and disposal of sharps is mandatory.
• Mandatory training and audits: Healthcare workers must undergo regular competency assessments, and institutions must conduct strict monitoring.

Why Action Is Important

“India has the manufacturing capacity to supply safety-engineered syringes at scale. The barrier is not technology, it is willpower. Procurement administrators must prioritize patient safety over short-term cost-cutting,” said Rajiv Nath, Forum Coordinator of the Association of Indian Medical Device Industry.

“Single-use devices like syringes, dialyzers, and AV (Arteriovenous) fistula needles must not be reused. Unsafe injection practices are entirely preventable, and continuing them is indefensible,” he added.

The expert urged policymakers to act now because it is affecting

• Public Health : Treating HIV, HBV, and HCV infections acquired through unsafe injections costs far more than investing in safe injection devices.

• Global Credibility: As one of the world’s largest users of injectable medicines and vaccines, India’s leadership in safe injection, drug delivery, and blood management practices is critical to global health security.

• Patient Trust: Every reused syringe erodes confidence in healthcare institutions and undermines national health programs.

Read More: Ebola Alert In India: Rajasthan, Hyderabad Report Suspected Cases of Deadly Virus

Call to Action

The AiMeD stated that the NMC's advisory must be treated as a binding mandate, not a suggestion. Procurement administrators, hospital authorities, and policymakers should:

• Enforce zero tolerance for device reuse across all healthcare facilities.
• Allocate budgets for safety-engineered syringes, including auto-disable syringes and sharps injury-prevention devices, as a public health investment rather than a discretionary expense.
• Establish accountability mechanisms through accreditation schemes, including audits, reporting of needle-stick injuries, and penalties for non-compliance.
• Launch patient awareness campaigns to empower communities to demand safe injection practices.

"Unsafe injection practices are not a matter of affordability but of accountability. India has the capacity, technology, and cost-effectiveness evidence through Health Technology Assessment (HTA). What is needed now is decisive action to protect patients and healthcare workers alike," the AiMeD said.

Survival rates among patients with high-grade gliomas — one of the most aggressive forms of brain cancer — have improved by up to 50 per cent in India, according to leading oncologists ahead of World Brain Tumour Day 2026.

Doctors say a growing number of patients are now living significantly longer after diagnosis, with some surviving for more than a decade.

Advances Boost Survival Outcomes

Dr. Tejinder Kataria, Chairperson of Radiation Oncology at Medanta, said median survival for many high-grade glioma patients has increased from around 9–12 months to 14–18 months.

She noted that some centers are "reporting nearly 40 per cent two-year survival rates among patients with Grade III and Grade IV gliomas. In addition, about 5 per cent of patients in certain high-grade glioma groups are now surviving for more than 10 years".

Experts attribute these improvements to advances in molecular diagnostics, comprehensive genomic profiling, neuronavigation-assisted surgery, precision radiation therapy, and targeted treatments.

“Radiation oncology has evolved from open beams in the cobalt era to highly precise beam configurations using modern technologies. We are now able to deliver tumoricidal doses more accurately while also preserving quality of life,” Dr. Kataria said.

Personalized Treatment Changing Care

Also read: Ebola Alert In India: Rajasthan, Hyderabad Report Suspected Cases of Deadly Virus

Dr. R. Ranga Rao, Chairman of Medical Oncology at Paras Health, said brain tumor treatment is no longer limited to surgery and radiation.

A deeper understanding of tumor biology is enabling doctors to tailor treatment according to the molecular profile of each patient’s cancer.

“Although high-grade gliomas remain challenging to treat, the combination of precision diagnostics, modern therapies, and multidisciplinary specialist care is helping more patients live longer and maintain a better quality of life than was possible even a few years ago,” Dr. Rao said.

He also highlighted the growing role of whole genomic sequencing, which helps clinicians understand a tumor’s genetic makeup and select more personalized treatment strategies that may improve survival.

Patients Should Not Lose Hope

Dr. Shyam Agarwal, Senior Consultant in Medical Oncology at Sir Ganga Ram Hospital, said many patients fear the worst when diagnosed with a brain tumor.

“People often feel that nothing can be done once they hear the word tumor in the brain. But brain tumors are of many different types — benign and malignant — and even malignant tumors vary widely in behavior,” he said.

According to Dr. Agarwal, modern treatment options, including surgery, radiation, targeted therapies, and newer drugs, can control many brain cancers for extended periods and may even offer a cure in selected cases.

He also stressed the importance of molecular testing and comprehensive genomic profiling to identify patients who may benefit from precision medicines.

Late Diagnosis Remains a Major Challenge

Despite advances in treatment, experts say delayed diagnosis remains a significant problem in India.

“The biggest blind spot in our country is that many patients reach specialists at a late stage. Symptoms may masquerade as routine headaches, hearing deficits, or visual disturbances. We need greater awareness,” Dr. Kataria said.

Dr. Agarwal added that delayed diagnosis is due to symptoms such as persistent headaches, hearing problems, or vision disturbances which are often mistaken for stress, migraine, or other common conditions, leading to late referrals.

What Is Glioma?

As per the Johns Hopkins Medicine, glioma is a common type of tumor originating in the brain. About 33 per cent of all brain tumors are gliomas, which originate n the glial cells that surround and support neurons in the brains, including astrocytes, oligodendrocytes and ependymal cells.

Gliomas are called intra-axial brain tumors because they grow within the substance of the brain and often mix with normal brain tissue. Symptoms include

• Headaches
• Seizures
• Personality changes
• Weakness in the arms, face or legs
• Numbness
• Problems with speech
• Nausea and vomiting
• Vision loss
• Dizziness.

With advancements in medical technology, hip replacement surgery has evolved significantly over the years. One of the most promising innovations in this field is the Direct Anterior Approach (DAA) Total Hip Replacement, a modern technique that offers patients a safer procedure, reduced pain, and faster recovery.

Unlike traditional hip replacement surgeries, the DAA technique allows surgeons to access the hip joint from the front through a small incision. The biggest advantage of this approach is that muscles are not cut during the surgery. Instead, they are gently separated, which helps minimize tissue damage and reduces post-operative pain considerably.

This muscle-sparing approach has transformed patient recovery experiences. Most patients are able to stand and walk on the same day of surgery, and hospital stays are generally shorter. Recovery is smoother, allowing individuals to return to their normal routine within three to four weeks in most cases.

The DAA technique is especially beneficial for patients suffering from chronic hip pain, restricted movement, or severe joint damage. Common conditions that may require hip replacement include osteoarthritis, avascular necrosis (AVN), rheumatoid arthritis, old hip fractures, and long-standing degenerative joint conditions. When medications, physiotherapy, and injections fail to provide lasting relief, hip replacement surgery can significantly improve mobility and quality of life.

Compared to conventional hip replacement procedures, DAA offers several advantages. The surgery involves a smaller incision, less blood loss, minimal muscle damage, and lower post-surgical discomfort. Patients are able to regain movement faster and often experience greater confidence during rehabilitation.

One of the most common concerns among patients is the fear of severe pain after surgery. However, with modern pain management techniques and advanced surgical methods, discomfort after DAA hip replacement is usually minimal and manageable. Patients today recover much more comfortably than they did in the past.

Another important factor is the durability of modern implants. Advances in implant technology have significantly improved their lifespan, with many implants lasting more than 25 years. Maintaining a healthy body weight, staying physically active, and following medical advice can further improve the longevity and effectiveness of the implant.

After successful recovery, patients are generally able to resume a normal and active lifestyle. They can return to work, perform household activities independently, and participate in light exercises such as yoga, swimming, and stationary cycling. The primary goal of hip replacement surgery is not just pain relief, but restoring confidence, mobility, and independence.

Preparation before surgery also plays an important role in achieving better outcomes. Patients are advised to maintain controlled blood sugar levels, blood pressure, and overall heart health. Informing doctors about ongoing medications, performing basic physiotherapy exercises before surgery, and preparing a comfortable recovery environment at home can contribute to a smoother rehabilitation process.

Hip pain should never be ignored, especially when it begins affecting daily life and mobility. Timely treatment and the right surgical approach can make a remarkable difference. The Direct Anterior Approach has made hip replacement surgery simpler, safer, and more patient-friendly, helping individuals return to an active and pain-free life much faster than before.

Dr. Ishwar Bohra is Senior Director and Senior Joint Replacement Surgeon at BLK-Max Super Speciality Hospital, New Delhi.