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.

You may not smoke, exercise regularly, maintain a healthy weight and have no known medical condition. But could the air you breathe still increase your risk of stroke?

The answer is yes. Air pollution affects more than the lungs; it is associated with cardiovascular disease and stroke. PM2.5 fine particulate matter measuring 2.5 micrometres or less in diameter can penetrate deep into the lungs and trigger biological responses affecting blood vessels throughout the body.

How can polluted air affect the brain?

A stroke occurs when blood flow to part of the brain is interrupted or when a blood vessel ruptures.

PM2.5 exposure may contribute to inflammation, oxidative stress and dysfunction of the endothelium, the inner lining of blood vessels. It may also influence platelet activation and normal blood-clotting mechanisms, potentially favouring thrombosis.

Over time, prolonged exposure may contribute to atherosclerosis, the build-up of plaques inside arteries. If a plaque ruptures and a clot blocks an artery supplying the brain, an ischaemic stroke can occur. Air pollution may also affect blood pressure and cardiovascular function.

However, exposure does not inevitably cause a clot or stroke. It is one of several factors that may influence an individual's risk.

Also read: Breathe Easy This Diwali: Early Warning Signs & Precautions to Protect Children & Senior Citizens

Can apparently healthy people also be affected?

Yes. Having no diagnosed hypertension, diabetes, high cholesterol or heart disease does not eliminate pollution-associated stroke risk.

A systematic review published in the British Medical Journal in 2015 found that a 10 µg/m³ increase in short-term PM2.5 exposure was associated with approximately a 1.1% relative increase in stroke admissions or mortality. This is a population-level association, not an individual's absolute risk or proof of causation in a particular patient.

Who needs particular attention?

Older adults and people with hypertension, diabetes, dyslipidaemia, coronary artery disease, atrial fibrillation or a previous stroke or transient ischaemic attack (TIA) warrant particular attention because their baseline vascular risk is high.

Five practical steps to reduce exposure

• Check the AQI: Monitor air-quality readings, particularly during periods of severe pollution.
• Modify outdoor activity: Reduce prolonged or strenuous exercise when air quality is poor; choose cleaner environments or indoor exercise.
• Use appropriate protection: A well-fitting N95 mask can reduce inhalation of fine particles when outdoor exposure is unavoidable.
• Improve indoor air: Consider appropriately sized HEPA filtration and minimise tobacco smoke and other combustion-related pollution.
• Manage vascular risk: Monitor blood pressure, glucose and cholesterol when appropriate, and follow prescribed treatment.

Do not start aspirin or anticoagulants solely because pollution levels are high. These medicines carry risks and should be used only when clinically indicated under medical supervision.

Individual precautions help, but sustained improvements require cleaner transport, effective industrial emission controls and prevention of waste burning.

Stroke prevention must address established medical risk factors as well as avoidable environmental exposures. The air may look clear, but that does not guarantee it is clean. Protecting the air, we breathe is also an investment in the health of our brains.

By Dr. Ashish Susvirkar, Senior Neurologist and Movement Disorders Specialist, Bhailal Amin General Hospital, Vadodara

Patient developed severe malaria affecting his platelets, liver, kidneys and lungs, with the lung injury progressing to Acute Respiratory Distress Syndrome (ARDS) and requiring ventilator support.

A 45-year-old motorman developed life-threatening complications after malaria progressed to multi-organ failure, affecting his lungs, liver and kidneys and causing a significant drop in platelet count and blood pressure.

His lung function deteriorated severely, leading to Acute Respiratory Distress Syndrome (ARDS), a serious condition in which the lungs are unable to provide enough oxygen to the body. He required ventilator support with high levels of oxygen and pressure to help him breathe.

Malaria Progresses To Multi-Organ Failure

The patient was admitted in a severely ill condition after being diagnosed with malaria. By the time he reached the hospital, the infection had affected multiple organ systems.

His platelet count was low, while his liver and kidneys were affected. The most critical complication was severe lung involvement. The patient developed ARDS, resulting in significant difficulty in maintaining adequate oxygen levels and requiring mechanical ventilation. His blood pressure had also dropped significantly, necessitating medicines to support his circulation.

Also read: NHS Data Shows 12% Increase In Kidney Cancer In People Under 50: Experts Flag Overlooked Signs

Severe Lung Injury Requires Ventilator Support

Malaria can sometimes become severe and affect multiple organs. In this patient, the lungs were particularly badly affected and he developed Acute Respiratory Distress Syndrome, or ARDS.

In ARDS, the lungs become severely inflamed and are unable to transfer sufficient oxygen into the bloodstream. He therefore required ventilator support, including higher oxygen and controlled pressure to help maintain adequate oxygenation. At the same time, we had to support his blood pressure and closely monitor his liver and kidney function.

Intensive Treatment Helps Patient Recover Without Dialysis

The patient was treated with appropriate anti-malarial therapy along with intensive supportive care. He was placed on ventilator support because of severe respiratory failure and was given medicines to maintain his blood pressure. His fluid status was carefully managed, while his urine output and kidney function were closely monitored.

Despite the initial kidney involvement, his urine output gradually improved and he did not require dialysis. Over the next several days, his lung function also began to improve. As his oxygenation and overall condition stabilised, the medical team was able to gradually reduce the level of ventilator support and eventually take him off the ventilator.

After approximately 7–8 days of intensive treatment and monitoring, the patient showed significant clinical improvement. He was successfully weaned off ventilator support, regained his strength and was able to walk before being discharged from the hospital.

The patient came in a very critical condition, with the lungs, liver and kidneys affected and blood pressure requiring support. The first few days were particularly important because we had to support several organ systems simultaneously while treating the malaria. His urine output improved without the need for dialysis, and his respiratory status gradually recovered. Within about a week, he was off the ventilator and eventually walked home.

When Can Malaria Become Life-Threatening?

The case highlights that malaria can, in some patients, progress beyond fever and routine symptoms and cause severe complications involving multiple organs. Lung involvement can be particularly serious, and conditions such as ARDS may require prolonged respiratory support in an intensive care setting.

Doctors advise people with malaria to seek timely medical attention, particularly if fever is accompanied by breathing difficulty, reduced urine output, unusual drowsiness, persistent vomiting, bleeding, severe weakness or low blood pressure. Early recognition of complications and appropriate supportive care can be critical in preventing further deterioration.

Diwali is a time of celebration, but the increase in air pollution caused by firecrackers can pose serious health risks, particularly for children and senior citizens. Exposure to smoke, harmful gases and fine particulate matter can irritate the respiratory system, worsen existing health conditions and put additional strain on the heart. Families must recognise early warning signs and take timely precautions to ensure everyone celebrates safely.

Who Is Vulnerable During Severe Pollution Days?

Also read: Delhi Becomes World's Most Polluted City Ahead Of Diwali, Says Swiss Agency: Experts Recommend Precautions

Children are particularly vulnerable because their lungs are still developing and they breathe faster than adults. Exposure to polluted air can cause coughing, sneezing, throat irritation, red or watery eyes and wheezing. Parents should watch for signs such as persistent coughing, difficulty breathing, unusual tiredness during physical activity or an increase in asthma symptoms. Even children who do not directly burst crackers can experience these effects through second-hand exposure to firecracker smoke.

Senior citizens, especially those living with asthma, chronic obstructive pulmonary disease (COPD), diabetes or heart disease, also face increased risks. Warning signs include worsening breathlessness, persistent cough, chest discomfort, unusual fatigue, dizziness and disturbed sleep. Pollution exposure can aggravate existing respiratory conditions and increase cardiovascular stress. Sudden chest pain, severe breathlessness, fainting or confusion should never be ignored and require immediate medical attention.

How To Stay Safe?

Also read: With Delhi AQI Nearing 400, Pollution & Flu Loom Ahead Of Diwali: What Happens When Both Hit Your Lungs?

A few simple precautions can significantly reduce exposure. Families should keep children and elderly members away from areas where firecrackers are being burst, particularly during peak evening hours. Keeping windows and doors closed when outdoor pollution levels are high can help limit smoke entering the house. Avoid burning incense sticks, dhoop and other materials indoors, as these can further deteriorate indoor air quality.

If stepping outdoors is unavoidable, adults can use a well-fitted N95 mask to reduce exposure to fine particulate matter. Children should be supervised and protected from smoky environments. Individuals with asthma or COPD must continue their prescribed medication and keep their inhalers readily accessible. Families should also avoid outdoor walks and strenuous activities the morning after Diwali if pollution levels remain high.

Beyond air pollution, families must remain alert to firecracker-related injuries. In case of burns, hold the affected area under cool running water for 20 minutes and cover it loosely with a clean cloth. Avoid applying ice, toothpaste or butter. Eye injuries and accidental ingestion of harmful substances require immediate medical evaluation.

Recognising early symptoms, limiting smoke exposure and seeking timely medical care can prevent avoidable complications. This Diwali, prioritise health and safety alongside celebrations. After all, a healthy family is the greatest reason to celebrate.

By Dr Nakul Sayta, Emergency Physician, Bhailal Amin General Hospital, Vadodara