Diabetes-related cognition problems; protecting children from chemicals
Q: I’m 68 and have had Type 2 diabetes for 12 years. My oral medications work pretty well, but I am beginning to have some memory issues and I don’t feel as steady as I used to. I read something about a nasal insulin spray that might help. Any info would be appreciated. — Jessie R., Louisville, Kentucky
A: Type 2 diabetes causes a wide variety of complications, including premature brain aging and dementia. That’s because insulin doesn’t just regulate blood glucose levels, it’s also used in the brain to allow blood vessels and neurons to interact correctly. If there is a lack of insulin production and/or insulin resistance, as happens in Type 2 diabetes, that diminishes brain function. Also, slow walking speed and unsteady gait may be signs of an inadequate blood flow to the brain (a result of diabetes-related inflammation of blood vessels), and that can cause cognition problems.
Recently, Harvard researchers, some with ties to the pharma company that makes the insulin nose spray, conducted a phase 2, randomized, double-blinded trial (that means it isn’t ready for Food and Drug Administration approval yet) looking at 24 weeks of treatment with intranasal regular insulin spray and 24 weeks of follow-up observation. The researchers saw that the participants taking the nasal spray had better executive functioning while getting treatment — and afterwards — and better memory during follow-up. They also had a faster walking speed than before treatment.
It’s too soon to know if this will truly become a therapy for diabetes-related cognition and mobility problems. A couple of phase 3 trials that show long-term benefits and risks compared to other newer diabetes meds such as GLP-1 and SGLT2 and FDA review are still needed. What we do know is that if you maintain tight control of your Type 2 diabetes, you can do a lot to protect yourself from brain and body complications. So, enjoy brain games (Google “speed of processing games”) and ask your doctor for a referral to a diabetes educator, nutritionist and physical therapist who can help you design a lifestyle renovation to enhance your cognition and mobility.
Q: I’m trying to raise my children in an environment as free of toxic chemicals as possible, and I particularly want to avoid PFAS. Are “green” toys and avoiding flame-resistant clothes a good way to keep these chemicals away from my kids? — Rose W., Memphis
A: Perfluoroalkyl and polyfluoroalkyl substances have been dubbed “forever chemicals.” They show up in everything from stain, oils, and water repellents to flame retardants, and don’t break down over time or fade away. Although they are now being phased out of some products or outright banned, the FDA has authorized specific PFAS for use in certain food-contact applications, such as cookware, food packaging and food processing because of their nonstick and grease-, oil- and water-resistant properties. And don’t be fooled by “green” and “nontoxic” labels.
A study published in Environmental Science & Technology found PFAS in kids’ products labeled as stain-resistant, water-resistant, “green” and “nontoxic,” such as bedding, furnishings and clothing. In addition, upholstered furniture, clothing and pillow protectors, most from China, were found to contain a form of PFAS now banned in the U.S. — PFOA.
That’s why cast-iron and stainless-steel pans, unprocessed foods and natural fibers are seen as healthier choices.
What harm can PFAS do? According to the National Institute of Environmental Health Sciences, they’ve “been linked to many negative health impacts, including developmental and behavioral outcomes in young children.” That translates to everything from endocrine disruption to slow bone growth in childhood, and obesity and heart disease as an adult. There’s also evidence that PFAS can interfere with the effectiveness of childhood vaccines and the ability to fight off infection.
Places like Green Science Policy Institute and Cradle to Cradle Certified provide info on Pfas-free products. You may not be able to avoid all PFAS, but being aware and careful can help reduce exposure.
Health pioneer Michael Roizen, M.D., is chief wellness officer emeritus at the Cleveland Clinic and author of four No. 1 New York Times bestsellers. His next book is “The Great Age Reboot: Cracking the Longevity Code for a Younger Tomorrow.” Do you have a topic Dr. Mike should cover in a future column? If so, please email questions@greatagereboot.com.