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.

A sugar naturally found in red meat may help explain why beef and lamb have long been linked to type 2 diabetes, according to a large new study presented at the European Association for the Study of Diabetes’ Annual Meeting in Milan.

Researchers tracked nearly 90,000 adults with no history of diabetes or cancer through NutriNet-Sante, a long-running French health study, according to a release from the European Association for the Study of Diabetes (EASD). Over a median follow-up of 7.2 years, 966 participants developed type 2 diabetes.

The focus was a sugar called N-glycolylneuraminic acid, or Neu5Gc, found mainly in beef and lamb. People with the highest intake of meat-derived Neu5Gc had a 63% higher risk of developing type 2 diabetes than those with the lowest intake, the EASD reported. The risk rose steadily with intake: the second-highest group already carried a 41% higher risk.

“This is a relative risk: people in the top fifth of meat-derived Neu5Gc intake had a 63% higher risk than those in the bottom fifth, after accounting for many other factors,” said lead author Dr. Leopold Fezeu of Universite Sorbonne Paris Nord told Medical News Today. “It does not mean that 63% of high consumers will develop diabetes.”

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Why Scientists Suspect Inflammation

Most mammals produce Neu5Gc naturally, but humans lost that ability after an ancient genetic mutation, according to the EASD. The sugar can still enter the body through food and get absorbed into human tissue. Because the body doesn’t recognise Neu5Gc as its own, the immune system may treat it as foreign, producing antibodies against it in a prolonged immune response called xenosialitis, previously linked to cardiovascular disease and cancer.

“Our findings support chronic inflammation as a specific mechanism linking red meat consumption with T2D, partly beyond the amount of red meat a person eats and partly independent of body fat,” Fezeu said.

What Are The Key Findings?

Not just weight: Notably, obesity accounted for only about 13% of the link between Neu5Gc intake and diabetes risk, the EASD reported, suggesting the sugar’s effects may extend beyond weight gain alone.

Dairy showed no link: Despite also containing Neu5Gc, dairy products showed no association with diabetes risk, likely because cow’s milk contains far smaller amounts than red meat.

An important caveat

When researchers additionally adjusted for total red meat intake, the Neu5Gc-diabetes link weakened and was no longer statistically significant, though it pointed the same direction.

“There may be differences between sources, or other components of red meat may contribute,” Fezeu said, meaning the study can’t fully separate Neu5Gc’s effect from red meat generally.

What comes next

Since the study is observational, it cannot prove Neu5Gc causes diabetes. Fezeu’s team plans to measure antibodies against Neu5Gc directly and study how it interacts with iron in red meat.

“Future research should explore whether reducing exposure to meat-derived Neu5Gc, for example by favoring poultry or plant-based proteins over beef and lamb... could help prevent T2D,” Fezeu said.

As we brace ourselves for another bout of winter, we can’t help but feel wary about the changes the dip in temperature brings on our mood and mental well-being. You are not imagining winter depression when you start to feel sudden loss of joy.

Seasonal depression is more than feeling gloomy. You may no longer enjoy the activities you once relished, like listening to music, exercising or meeting friends. This isn’t just another effect of winter. Experts have designated a term for it: anhedonia.

Anhedonia refers to the loss of pleasure or interest in something you once enjoyed. It is one of the symptoms of depression, including seasonal affective disorder (SAD). Unlike sadness, anhedonia can render someone feeling disconnected with or indifferent towards things they once enjoyed.

A person experiencing anhedonia may still participate in activities they enjoy but will no longer reap emotional rewards from it.

“Anhedonia is not the kind of sadness where you’re feeling down but still have moments of enjoyment,” Dr Deeksha Kalra, Associate Consultant, Psychiatry, Artemis Hospital, Gurugram, explained to HealthandMe.

Dr Samant Darshi, Consultant Psychiatrist and Neuromodulation Expert at Yatharth Hospitals, told us, “While sadness entails the state of feeling unhappy about something, anhedonia pertains to the lack of enjoyment.”

Dr Kalra said, during SAD, anhedonia may be experienced during the affected season like winter.

“This can happen at the same time as low mood, but it can also be one of the clearest symptoms. In SAD, these changes are usually present during the affected season and resolve with the resolution of the depressive episode. So anhedonia is about muted pleasure, not just feeling sad,” Dr Kalra explains.

Effects Of Winter On Pleasure And Motivation

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Changes that come with SAD, a type of depressive phase, usually pertains to specific seasons, like mostly winter. Due to less duration of daylight, the body’s internal clock, known as circadian rhythm, may get affected. Along with circadian rhythm, poor diet, irregular sleep pattern and limited physical activity can also contribute to SAD.

This could cause one to feel difficult to initiative activities they enjoy as they no longer feel motivated, affecting the brain reward system.

“Seasonal affective disorder (SAD) causes disturbance of mood, sleep, energy, and motivation. Activities which were pleasurable before become less rewarding because of this. The changes in daylight hours may affect the body clock or the physiological processes related to mood control. The decrease in energy and motivation makes doing the activity even harder and less pleasurable,” said Dr Darshi.

Dr Kalra explains that there are a lot of phases to experiencing ‘enjoyment’. It involves identifying something rewarding, anticipating it, experiencing pleasure and learning from the experience. Depression can affect all these phases, making previously enjoyable activities feel less rewarding.

“Brain networks including the striatum and nucleus accumbens, contribute to the valuation of rewarding experiences and the motivation of behavior. When their responses are dulled and something that was once naturally rewarding may not have the same emotional resonance,” she says.

Dopamine’s Role In SAD

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Dopamine is a neurotransmitter in the brain responsible for motivation, rewards, learning, and directing behaviour as per goals. When we talk about SAD and anhedonia, dopamine comes into the picture as it is related to motivation and rewards.

Dr Kalra explained, “Dopamine is involved in motivation, reward anticipation, learning and determining the value of pursuing something. That’s why dopamine has been looked at when researchers have investigated anhedonia and low motivation.”

But doctors say that anhedonia is not characterised by shortage of dopamine. According to research, SAD has been reported to affect dopamine signalling, including lower dopamine transporter availability in the striatum during symptomatic depression.

Dr Darshi also emphasises that dopamine is only a part of the process.

He said, “Studies concerning depression and anhedonia indicate that changes in the activity of dopamine result in the decrease in motivation and reward sensitivity. However, anhedonia encompasses many brain processes.”

SAD And Anticipatory Pleasure

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Anhedonia makes one indifferent by directly affecting the anticipatory pleasure mechanism. Anticipatory pleasure is the excitement one feels before an event. Consummatory pleasure is the enjoyment experienced while the event is in progress.

“Anhedonia can affect the anticipatory pleasure you feel when you look forward to something and the consummatory pleasure you experience when it actually happens. Someone might know that a favorite meal, holiday or meeting with friends should be enjoyable but feel little excitement beforehand. The pleasure might also feel weaker than expected when the event happens,” Dr Kalra explains.

Not Everyone May Experience Same SAD Symptoms

Everyone with SAD experiences anhedonia in different ways. While some may lose interest and pleasure, others may withdraw socially, sleep excessively, eat more, feeling more tired among other symptoms.

“SAD doesn’t affect everybody in exactly the same way any more than depression is a single biological process. Different people can experience different combinations of changes in mood regulation, circadian rhythms, sleep, appetite and energy and reward processing,” says Dr Kalra.

She also said that multiple symptoms may interact. For example, poor sleep could result into daytime sluggishness, making energetic activities less tempting.

Dr Darshi explained, “Individuals with SAD have different presentations since biology, genetics, circadian rhythm, and psychology are unique for each person. Some individuals have disturbances in reward and motivation, whereas others have sleep disturbances or carbohydrate cravings, or even fatigue. Symptoms might be overlapping and are a reflection of various underlying mechanisms.”

Female breast cancer was the most commonly diagnosed cancer among women in India in 2024, with an estimated 237,231 new cases and 96,100 deaths, according to the International Agency for Research on Cancer (IARC).

Despite the importance of early detection, screening uptake remains low. Experts say India needs better access to screening and approaches tailored to age, breast density and individual risk.

Dr. Sandeep Nayak, Chairman of Oncology at MACS-Renova Oncology Institute, KIMS Hospital, Bengaluru, told HealthandMe that population-wide screening remains a distant goal, with opportunistic screening still the norm.

“Because of this, applying blanket Western guidelines is ineffective. We need a pragmatic, age-stratified approach to imaging: utilizing breast ultrasound (USG) for women aged 35 to 45—where dense breast tissue severely limits mammogram sensitivity—and reserving routine mammography for women above 50, where tissue density decreases and diagnostic yield peaks,” he said.

Why Is Breast Cancer Still Diagnosed Late in India?

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“The alarming epidemiological paradox is that while our incidence is a third of Western nations, our death rate already surpasses theirs. The issue is not that this cancer has an aggressive biology in India; it is the timeline of discovery,” said Dr. Navin Gnanasekaran, Head of Clinical Services, Radiology and Interventional Radiology for the Apollo Group Chennai Region.

Dr. Gnanasekaran said more than 60% of breast cancers in the United States are diagnosed while still localized, with five-year survival exceeding 90%. In India, many cases are detected after the cancer has spread beyond the breast, contributing to a five-year survival rate of 66.4%, he said.

India introduced population-based screening for common noncommunicable diseases in 2016 under the National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS), launched in 2010. The program includes breast cancer screening among women aged 30 and above.

However, National Family Health Survey-5 (NFHS-5) data show that only 0.9% of women aged 30–49 had ever undergone a breast examination for cancer detection. Dr. Gnanasekaran placed the median age of breast cancer onset in India at around 45.

Should Mammograms Start at 40—or Later?

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Experts differ when routine mammography should begin and whether breast density should influence imaging choices.

Dr. Gnanasekaran recommended digital mammography every two years for women aged 40–60. He proposed linking screening reminders to Ayushman Bharat Health Account (ABHA) IDs, deploying mobile mammography units in rural areas and using validated artificial intelligence (AI) to help interpret scans.

Dr. Nayak recommended ultrasound for women aged 35–45 and routine mammography for those above 50.

Dense breast tissue can make some cancers harder to detect on mammograms. Women at high genetic risk, including those with BRCA mutations or a strong family history, may need earlier surveillance, potentially including contrast-enhanced breast MRI in their late 20s or early 30s, depending on individual risk.

Dr. Gnanasekaran stressed that screening must be supported by accessible diagnostic and treatment services, including timely biopsies.

Is Mammography Safe, and Can It Miss Cancer?

Mammography can miss some cancers, particularly in women with dense breasts. Ultrasound may be added for dense breasts or specific concerns, while MRI is generally used for women at higher risk or in selected situations.

Dr. Garvit Chitkara, Associate Director of Breast Surgical Oncology and Oncoplasty at Nanavati Max Institute of Cancer Care, Mumbai, said the radiation risk from mammography is low, while false-positive results can lead to additional tests.

“At the recommended intervals, mammography does not meaningfully raise your cancer risk. The more real downsides are occasional false alarms that lead to extra tests, which is a reason to have it done at a good centre and discuss any call-back with your doctor,” he told HealthandMe.

A normal mammogram should not be used to dismiss a persistent lump or other breast symptoms. Women experiencing changes should seek medical evaluation even if their most recent screening result was normal.

Which Breast Changes Should You Never Ignore?

Many breast lumps are benign, including cysts and fibroadenomas, but touch alone cannot reliably distinguish a harmless lump from cancer.

“Any new lump, or a lump that is changing in size or feel, should be examined by a doctor. A quick check usually settles it and gives you peace of mind,” Dr. Chitkara said.

Persistent redness, itching or skin thickening, breast dimpling, puckering, an orange-peel texture, nipple retraction or unusual nipple discharge should also be evaluated.

Early breast cancer is often painless. Women should not wait for pain before seeking medical attention.