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Blood Sugar Control Linked to Memory Decline, Study Says

Could high dose steroids help cause chemo brain

Article Type: Side Effects
Author: By RONI CARYN RABIN
Publication Date: Published: December 31 2008
Source: New York Times
Source Type: online edition

Spikes in blood sugar can take a toll on memory by affecting the dentate gyrus, an area of the brain within the hippocampus that helps form memories, a new study reports.

Researchers said the effects can be seen even when levels of blood sugar, or glucose, are only moderately elevated, a finding that may help explain normal age-related cognitive decline, since glucose regulation worsens with age.

The study, by researchers at Columbia University Medical Center and funded in part by the National Institute on Aging, was published in the December issue of Annals of Neurology.

“If we conclude this is underlying normal age-related cognitive decline, then it affects all of us,” said lead investigator Dr. Scott Small, associate professor of neurology at Columbia University Medical Center. The ability to regulate glucose starts deteriorating by the third or fourth decade of life, he added.

Since glucose regulation is improved with physical activity, Dr. Small said, “We have a behavioral recommendation — physical exercise.”

In the study, researchers used high-resolution functional magnetic resonance imaging to map brain regions in 240 elderly subjects. They found a correlation between elevated blood glucose levels and reduced cerebral blood volume, or blood flow, in the dentate gyrus, an indication of reduced metabolic activity and function in that region of the brain.

By manipulating blood sugar levels in mice and monkeys, researchers said, they tried to confirm a cause-and-effect relationship between the glucose spikes and the reduced blood volume, Dr. Small said.

Bruce S. McEwen, who heads the neuroendocrinology lab at Rockefeller University in New York and was not involved in the research, said the study’s findings were “compelling,” with important implications not just for the elderly but for the growing number of overweight children and teens at risk of Type 2 diabetes.

“When we think about diabetes, we think about heart disease and all the consequences for the rest of the body, but we usually don’t think about the brain,” he said. “This is something we’ve got to be really worried about. We need to think about their ultimate risks not only for cardiovascular disease and metabolic disorders, but also about their cognitive skills, and whether they will be able to keep up with the demands of education and a fast-paced complex society. That’s the part that scares the heck out of me.”

Previous observational studies have shown that physical activity reduces the risk of cognitive decline, and studies have also found that diabetes increases the risk of dementia. Earlier studies had also found a link between Type 2 diabetes and dysfunction in the dentate gyrus.

Sheri Colberg-Ochs, an associate professor of exercise science at Old Dominion University in Norfolk, Va., said her research has found that regular exercise, even light physical activity, can offset the potentially negative effects of Type 2 diabetes on cognitive function. It is not clear what the mechanism is, she said, but may have something to do with the effect of insulin.

“This new study is interesting in that it allows for a greater understanding of which region of the hippocampus is likely most affected by poorly controlled diabetes,” she said.

But the elevations in blood glucose seen in the new study are more subtle and would not be considered a disease state, Dr. Small said.

“It’s part of the normal process of aging, much like wrinkling of skin,” he said. “It happens to all of us inexorably, and it worsens progressively across the life span.”

My doctor just told me that not even 1,000 people, worldwide, have undergone the stem cell procedure.  I found this to be very surprising.  The number seems very low.

Do these numbers mean anything?  Out of the thousands and thousands of people who have multiple myleoma and less than a thousand have done the stem cell procedure, does this mean the procedure is still experimental?

Hope this question isn't too stupid.  Thanks!

 

 

I don't know how many transplants have been done, but in 2007, the University of Arkansas for Medical Sciences had performed 7,000.  See the following website:

http://www.uams.edu/update/absolutenm/templates/news2003v2.asp?articleid=7005&zoneid=18

Deb-

I think your onc might have been talking about something else.  University Hospitals of Cleveland had performed over 200 peripheral blood stem cell transplants by 1994.

While there have been fewer autologous stem cell transplants performed, I think the number is still well above 2,000.

The term "experimental" is a definition used by the FDA,  Medicare and insurance companies.  If the FDA approves a drug or proceedure, if Medicare decides to pay for a drug or procedure, then insurance companies will generally pay for the drug or proceedure and it is not longer termed "experimental."

A peripheral blood stem cell transplant is still considered experiemental by the FDA, medicare and most insurance companies- no clinical trial has clearly shown that scts help mmers live longer than other therapies.  David

 

 

You don't say what kind of stem cell procedure. Assuming you mean autologous stem cell transplants. The UAMS is approaching their 10,000. Although no one else is close to that number. But as a total word wide I guess over 20,000.

Your question is not stupid but your doctor may be.

Joe Bartee

 

 

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