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.

Breast cancer is now the most commonly diagnosed cancer among women in India, representing a significant and growing public health concern. According to recent estimates, India recorded approximately 221,757 new breast cancer cases in 2022, making breast cancer the most common cancer among women and accounting for nearly one-fourth of all female cancers in several urban populations1.

Rising urbanisation, lifestyle changes, delayed childbirth, and increasing life expectancy have contributed to the growing incidence. Despite advances in awareness and screening, many women continue to be diagnosed at later stages, underscoring the need for effective, accessible, and patient-centric treatment approaches.

Moving Beyond One-Size-Fits-All Radiation Therapy

As cancer care evolves towards more personalised treatment, brachytherapy is emerging as a targeted alternative that delivers radiation with greater precision.

Also read: Why Flight Attendants, Pilots Face Higher Risk Of Radiation-Linked Cancer Deaths Than Other Occupations?

How Brachytherapy Delivers Radiation Where It Matters Most

Unlike conventional radiation, which passes through normal tissues before reaching the target, brachytherapy focuses treatment directly on the tumour bed. This precision helps maximise treatment effectiveness while reducing potential side effects.

Also read: Groundbreaking Experimental Vaccine May Prevent Pancreatic Cancer From Spreading, Early Trial Finds

A More Personalised Approach to Breast Cancer Treatment

One of the most significant applications of breast brachytherapy is Accelerated Partial Breast Irradiation (APBI). In selected patients with early-stage breast cancer, the risk of recurrence is highest around the original tumour site. APBI targets only this region rather than treating the entire breast.

This focused approach helps protect healthy breast tissue and nearby organs such as the heart and lungs. Advanced imaging and treatment-planning technologies further enhance personalisation by allowing radiation doses to be tailored to the patient's anatomy and tumour characteristics.

Also read: UK Set To Implement Stricter Protocol For Prostate Cancer Testing; Who Is Eligible To Get Tested?

Shorter Treatment Duration, Greater Convenience

A major advantage of brachytherapy is the shorter treatment schedule it offers. Conventional radiation therapy may require daily sessions for three to six weeks, whereas brachytherapy-based APBI can often be completed within a few days.

For patients travelling long distances to access specialised cancer care, this can reduce both the logistical and financial burden of treatment while minimising disruptions to daily life.

Preserving Quality of Life After Cancer

As survival rates improve, quality of life has become a key consideration in breast cancer care. Brachytherapy's targeted approach reduces radiation exposure to healthy tissues and has been associated with favourable cosmetic outcomes.

By combining precision, convenience, and effectiveness, brachytherapy represents an important step towards personalised breast cancer treatment, offering appropriately selected patients an opportunity for effective care with potentially fewer side effects and improved overall treatment experience.

By Dr. Harjot Kaur Bajwa, Senior Consultant Radiation Oncologist and Brachytherapy specialist at the American Oncology Institute, Hyderabad

Longevity expert and multi-billionaire Bryan Johnson has revealed another health condition affecting him. This time, it is meibomian gland dysfunction (MGD).

Johnson also said that the largely asymptomatic condition affects nearly 90 percent of adults over 40. The condition can "lead to permanent eye damage" and also affects younger people because of increased exposure to screens.

“I just learned that I have meaningful meibomian gland dropout. This is why my eyes are irritated,” Johnson said in a post on social media platform X.

“The dropout leads to evaporative dry eye disease, which triggers vision degradation such as blurred text, glare at night, light sensitivity, and neuropathic ocular pain. Left long enough, it can scar the cornea and permanently damage vision,” he added.

What Is Meibomian Gland Dysfunction?

Meibomian gland dysfunction happens when the tiny oil glands in the eyelids become blocked or produce poor-quality oil. This prevents enough oil from reaching the tears, causing them to dry up too quickly.

Major triggers include aging, hormonal shifts, screen use, and skin or eye inflammation, according to Cleveland Clinic.

Johnson explained that there are about “60 meibomian glands per eye, split across the upper and lower lid. They are like pores, secreting nourishing oil (meibum) onto your tear film to prevent rapid evaporation.”

He noted that the glands can become dysfunctional due to conditions or factors including "age, androgen deficiency, menopause, hormone replacement, oral contraceptives, isotretinoin, antihistamines, SSRIs, tricyclics, beta blockers, diuretics, anticholinergics, preserved eye drops, incomplete blinking, reduced blink rate, screen use, contact lens wear, and ocular rosacea".

When these glands become clogged, the meibocytes can die, and the gland can eventually drop out. Johnson said conventional medicine considers total gland dropout irreversible.

Why Can MGD Go Unnoticed?

Importantly, Johnson said that MGD can remain asymptomatic during its initial stages. When symptoms appear, the condition can resemble ordinary dry eye, allowing it to worsen and lead to permanent gland dropout.

Advanced MGD can also numb the cornea, further masking subjective symptoms as the disease progresses.

How Did Bryan Johnson Detect MGD?

Johnson's MGD was detected after he went to the doctor for a chalazion or stye, a painful, red bump on the edge of the eyelid.

He also mentioned undergoing diagnostic tests, including the Schirmer test and infrared meibography.

How Is Johnson Treating MGD?

Johnson began treatment with in-office intense pulsed light (IPL), radiofrequency (RF), and an experimental intraductal probing, known as the Maskin protocol, to address inflammation and physically reopen clogged glands.

The eye-light device combines IPL with 630-nm red low-level light. The proposed mechanism involves stimulating mitochondrial ATP production in meibocytes and reducing inflammation around the eyes.

The probing therapy involved using 1-mm, 2-mm, and 4-mm probes, which were inserted into each gland orifice.

“My doctor then expressed my glands, using a roller device to expel any buildup and kickstart the gland’s natural expression. This is really painful. Brings you to tears,” Johnson said.

Along with IPL, RF, and probing, he was also using warm eye compresses twice a day, in the morning and at night.

“With this protocol, we’ve seen a 30% improvement in meibomian gland function (using imaging). My glands look healthier, eye irritation has lessened, my subjective symptoms have subsided, and when we probe now, we encounter minimal fibrotic resistance (popping),” he said.

Signs of MGD to Watch For

Johnson listed several symptoms and warning signs to watch for, including:

• Burning or a gritty sensation in the eyes
• Vision that blurs and then clears when you blink
• Watery eyes, as dryness can trigger reflex tears
• Red, crusty or bumpy eyelid margins
• Recurring styes
• Contact lenses becoming uncomfortable
• Symptoms worsening when using screens, travelling on planes or staying in air-conditioned environments

Any of these symptoms, particularly after age 40, may warrant a gland examination, Johnson said.

August 18 marks World Breast Cancer Research Day, a day that reminds us that every major breakthrough in cancer care has its roots in research. The medicines that are prescribed, the diagnostic technologies that we use, the targeted therapies that we offer and our growing understanding of why cancers develop and spread, are all outcomes of regular scientific research.

India carries one of the world's largest cancer burdens. According to IARC's GLOBOCAN 2022 estimates, India recorded approximately 1.41 million new cancer cases and more than 916,000 cancer deaths in 2022. Breast cancer alone was the leading cancer among Indian women and also the leading cancer overall.

India as a country, has a large and diverse patient population, significant clinical expertise, strong medical institutions and a pharmaceutical industry with enormous manufacturing capabilities. But there is a crucial gap between manufacturing what the world has already discovered and researching newer medical opportunities.

A significant proportion of cutting-edge cancer research continues to emerge from countries with substantially larger and more established research ecosystems. When scientific discoveries, new molecules, diagnostic technologies or treatment approaches are developed elsewhere, Indian patients benefit from them at a later stage.

We Need To Move Beyond A Few Centres Of Excellence

We have limited institutes that have made important contributions to cancer care and research. But considering India's population and cancer burden, the scale of research infrastructure needs to expand substantially. We need more dedicated cancer-research institutes, stronger university hospital industry collaborations, modern laboratories, biobanks, genomic databases, data-science capabilities and trained physician-scientists.

Cancer is not just one disease. It comprises of multiple biological subtypes, and the way a tumour behaves can vary significantly between individuals and populations. Therefore, India needs research that focusses specifically towards Indian patients.

Also read: Groundbreaking Experimental Vaccine May Prevent Pancreatic Cancer From Spreading, Early Trial Finds

Clinical Trials Can Be Part Of The Solution

India has a formal Clinical Trials Registry, and the registry currently records more than 100,000 trials across areas of medicine.

For eligible patients, participation in an appropriate clinical trial may provide access to an investigational therapy or treatment strategy that is not yet routinely available. Clinical trials generate evidence that can improve future treatment for thousands or millions of patients.

Also read: UK Set To Implement Stricter Protocol For Prostate Cancer Testing; Who Is Eligible To Get Tested?

Research Needs To Become A Policy Priority

We need to create an ecosystem that moves from discovery to translation to patient care. That means incentivizing research institutions and researchers, supporting young physician-scientists, strengthening public-private partnerships and making it easier for promising discoveries to move from laboratories into clinical development.

We need to have an ecosystem, where healthcare research, particularly research addressing diseases with an enormous Indian burden should receive a much greater and more targeted share of national research investment. A large, diverse population can generate valuable real-world evidence. Large patient cohorts can help researchers understand disease patterns. Indian genetic and molecular data can help answer questions that may not be adequately addressed through studies conducted in other countries.

From Manufacturing Medicines To Discovering The Next Generation Of Treatments

India has already demonstrated that it can serve the world as a pharmaceutical manufacturing powerhouse. We should look at also becoming the research hub for the world by combining our pharmaceutical manufacturing strength, clinical expertise, technology capabilities and patient population.

The opportunity is already in front of us.

What we need now is the policy ambition to implement it.

By Dr. Kapil Goyal, Consultant – Medical Oncology, Rajiv Gandhi Cancer Institute & Research Centre (RGCIRC)