RISING CONCERNS: DEMENTIA AND ALZHEIMER'S DISEASE AMONG DIABETIC PATIENTS IN INDIA
In recent years, India has been grappling with a dual health challenge that affects millions: diabetes and the associated risks of dementia and Alzheimer's disease. Among the South Asian population, including Indians, the prevalence of these neurodegenerative conditions has been steadily increasing, presenting unique challenges and complexities.
Prevalence and challenges
India, often referred to as the diabetes capital of the world, also faces a significant burden of dementia and Alzheimer's disease among diabetic patients. Recent studies indicate that individuals with diabetes are at a higher risk of developing dementia compared to those without diabetes. The reasons behind this correlation are multifaceted, ranging from vascular damage due to high blood sugar levels to insulin resistance affecting brain function.
Among South Asians, genetic predispositions combined with lifestyle factors such as diet and exercise patterns contribute to the increased susceptibility to both diabetes and neurodegenerative diseases. This demographic is particularly vulnerable to the onset of cognitive decline and memory loss associated with Alzheimer's disease.
Early signs and symptoms
The early stages of dementia and Alzheimer's disease often manifest in subtle ways, which can be challenging to recognize. Patients may experience memory loss that disrupts daily life, difficulty in solving problems, confusion with time or place, and changes in mood or personality. For diabetic patients, these symptoms can be exacerbated by factors such as fluctuations in blood sugar levels, leading to episodes of forgetfulness or confusion.
Case study: A patient's struggle
In Mumbai, Mrs. Suman Jha (name changed to protect patient’s privacy), a 75-year-old with a gentle smile and a resilient spirit, has spent decades battling type 2 diabetes and hypertension. For over 25 years, she meticulously managed her health with basal and bolus insulin, a routine her late husband had once helped oversee with loving care. After his passing, her only daughter took on the responsibility of looking after her.
As time passed, it became increasingly challenging for her daughter to manage a full-time job, a toddler, and her own family alongside caring for her mother, who would miss her insulin or sometimes take repeated dosages. One day, Mrs. Jha accidentally took insulin twice and forgot to eat her meals, leading to dangerously low blood sugar levels. Her daughter, alerted by concerned neighbors, found her unresponsive in bed, requiring immediate medical attention and hospitalization.
Despite hiring help, gaps in care emerged, leaving Mrs. Jha vulnerable. Her daughter agonized over the decision, knowing her mother deserved both safety and a fulfilling life. Ultimately, a carefully chosen facility offered a solution—a place where skilled professionals could ensure Mrs. Jha's medical needs were met while also stimulating her mind with activities she once loved.
Initially apprehensive, Mrs. Jha soon adapted beautifully. In this new chapter of her life, she found unexpected joy and purpose. Surrounded by peers who share similar life experiences, she formed new friendships. Each day, she engages in activities that spark memories, however fleeting, and embraces the moments of connection that Alzheimer's couldn't steal. Her daughter visits often and, seeing her mother's contented smile, knows she made the right choice.
The way forward
As India continues to witness a surge in diabetes cases, healthcare professionals must emphasize the importance of early detection and integrated care for patients susceptible to dementia and Alzheimer's disease. Regular cognitive assessments, along with meticulous management of diabetes and related medications, are crucial steps in mitigating the risks associated with cognitive decline.
Alzheimer's, often termed "type 3 diabetes," shares a pathophysiological link with insulin resistance—a hallmark of type 2 diabetes. This realization underscores the importance of stringent diabetes control. Ongoing research into the repurposing of anti-diabetic medications, such as GLP-1 receptor analogues and GLP-1 receptor agonists, shows promise in reducing neuroinflammation and protecting neurons in the brain.
In conclusion, the convergence of diabetes and neurodegenerative diseases presents a formidable health challenge for India's aging population. Increased awareness, timely interventions, and community support are essential in addressing these intertwined health issues effectively.
This article aims to shed light on the pressing issues faced by diabetic patients in India concerning dementia and Alzheimer's disease, highlighting both the prevalence among South Asians and the critical need for early recognition and intervention.
Authored by: Dr. Rajiv Kovil, Head of Diabetology, Zandra Healthcare and Co-founder of Rang De Neela initiative READ ALSO: Insulin awareness day: What is insulin therapy? READ ALSO: Insulin resistance among youth: Causes and preventive measures