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June 9, 2009

Behavior, Other Medications

Question from Columbia, South Carolina, USA:

I have had type 1 diabetes going on 24 years. In October 2008, I was diagnosed with ADHD and placed on Adderall XR 10 mg daily. I recently saw a story on t.v. that looked at the relationship of type 2 diabetics having one incident of severe low blood sugar and a 30% increase in the prevalence of getting Alzheimer's disease. In addition, having multiple cases of extreme low blood sugars caused prevalence of Alzheimer's disease rates in these patients to increase to 98%. While I have noticed an improvement in my memory and an obsession with cleaning my house every day, I still notice, from time to time, forgetting things such as misplacing my keys or forgetting to do things even though my stimulant medication has been increased to a twice daily dosing rate now. When I was younger, I experienced extreme low blood sugars and only within the past two years have I been on pump therapy. Have you or your colleagues seen the same thing in long term diabetic patients such as higher prevalence of forgetfulness? What advice would you give?

Answer:

I am not sure where the data you are sharing comes from. There have been several intensive control trials with type 1 diabetes, and the increased frequency that comes with hypoglycemia does not necessarily equate to a decrease in intelligence or mental function long-term, despite the fear that it might. Type 2 diabetes has been more closely associated with Alzheimer’s disease. Both are associated with abnormalities in protein processing. However, type 1 diabetes has not been associated as strongly with Alzheimer’s disease. Some of the things you describe are naturally occurring in every day life. I am not sure you have to blame that on the development of dementia.

JTL