Sweet Smarts: Type 2 Diabetes and Cognitive Health

Written By Jennifer Palmquist

If you’re already managing your diabetes or making lifestyle changes to prevent it, you’re doing your brain a huge favor. Type 2 diabetes isn’t just about blood sugar – it’s about brain health, too. Studies show that unmanaged type 2 diabetes significantly increases the risk of developing dementia. The longer you live with uncontrolled diabetes, the greater the threat to your memory and thinking. In this article we will explain this link and help you take action to control your blood sugar and reduce those risks. What you do to treat or prevent diabetes today can help preserve your brain health for tomorrow.

But it's important to remember, this is only one of many modifiable behavioral risk factors for Alzheimer's and dementia. 

If you'd like a personalized plan, daily activities and support to help address all of your most pressing risks, sign up for a 2 week free trial of Mindr. Better brain health starts today. 

Why Diabetes Raises Dementia Risk

There’s a good reason Alzheimer’s disease has been called type 3 diabetes. The two diseases share many molecular and cellular features. For example, insulin not only helps your body regulate blood sugar but also contributes to the formation of amyloid and tau plaques in the brain found in Alzheimer’s disease. In both Alzheimer’s and diabetes, cells become less responsive to insulin.

Diabetes seldom comes alone though – it often brings along other friends that the brain doesn’t like. People with diabetes are more likely to also have high blood pressure, high LDL cholesterol, and obesity. Each of these conditions further increases dementia risk on its own. When combined, their effects can multiply. For example, diabetes plus hypertension can damage the brain’s small arteries, leading to white matter changes and cognitive decline. The takeaway: diabetes is a double threat – it harms the brain directly and indirectly by inviting other bad actors to the party.

Having type 2 diabetes more than doubles the risk of Alzheimer’s disease and other forms of dementia in later life. In fact, a large analysis of 28 studies found that individuals with type 2 diabetes had about a 73% higher chance of developing any dementia compared to those without diabetes. That’s a serious increase in risk, on par with other major factors like smoking or high blood pressure. The heightened risk is even more pronounced for vascular dementia (memory loss caused by strokes and blood vessel damage) – diabetes can more than double that risk, especially in women. Simply put, chronically high blood sugar and insulin resistance can wreak havoc on the brain over time.

One important factor is when diabetes occurs. Mid-life onset of type 2 diabetes appears especially harmful to the brain. Research indicates that getting diabetes in mid-life is linked to a significantly higher dementia risk, whereas developing diabetes very late in life (e.g. after age 70) might have less impact. Why? The duration of diabetes and its cumulative damage seem key – the earlier diabetes starts, the longer it can affect the brain’s blood vessels and metabolism. Over years and decades, high blood glucose can stiffen and narrow the blood vessels that nourish the brain, leading to small “silent” strokes and reduced blood flow. Diabetes also triggers inflammation and oxidative stress, which can accelerate aging in the brain.

That all sounds pretty scary, but here’s the encouraging part: recognizing diabetes as a dementia risk gives you a head start on protecting your brain. Unlike fixed risk factors (such as age or genetics), diabetes is highly manageable. In fact, the 2024 Lancet Commission on dementia and public health experts emphasize that managing chronic conditions like diabetes is a crucial strategy for reducing dementia risk. By keeping your blood sugar under control, you can substantially reduce your chances of developing dementia.

Brain-Friendly Ways to Manage Diabetes

Living with type 2 diabetes means making daily choices that don’t just affect your blood sugar, but also the long-term health of your brain. The same healthy habits that doctors recommend for diabetes can shield your memory and thinking. Here are specific, research-backed actions to consider:

  • Control Blood Sugar Levels: Keeping your HbA1c (a three-month blood sugar average) in the target range set by your doctor is priority one. High blood sugar over time damages blood vessels in the brain. Work with your healthcare provider to monitor your levels regularly. If you have diabetes, take medications as prescribed – studies suggest that some diabetes medications may be associated with lower dementia risk in the long run. Avoid frequent extreme highs or lows in your blood sugar, as both can be harmful to the brain. Steady control is the goal.

  • Embrace a Healthy Diet: Diet is a powerful tool for managing diabetes and protecting the brain. Focus on a balanced, low-glycemic diet – one that is rich in vegetables, fruits, whole grains, lean protein, and healthy fats, and low in refined sugars and processed foods. This is similar to the Mediterranean, DASH and MIND diets that benefit heart health. A nutritious diet helps keep blood glucose stable and provides essential nutrients for brain function. By eating plenty of fiber and cutting back on sugary drinks and sweets, you’ll prevent sharp blood sugar spikes that can strain your body and mind. Remember, no single food will prevent dementia, but overall healthy eating can reduce your risk of both diabetes complications and cognitive decline. If you’re already eliminating processed foods and eating more whole foods – great job! Those efforts help both your body and brain.

  • Stay Active: Physical activity improves your body’s use of insulin and lowers blood sugar – and it’s a boon for your brain. Aim for at least 30 minutes of moderate exercise most days (with your doctor’s approval). Aerobic exercises like walking, cycling, or swimming improve circulation and help control blood sugar. Strength training a couple times a week can build muscle, which increases the insulin sensitivity of your cells. In the landmark FINGER study, older adults who followed an exercise program (along with other healthy habits) showed better cognitive performance. Exercise also helps reduce inflammation and can elevate your mood. If you’re new to exercise, check with your doctor first and start slowly. Pick activities you enjoy, whether it’s gardening, dancing, or a gentle yoga class. Every bit helps – even a short walk after meals can lower post-meal blood sugar and, over time, protect your brain’s blood vessels.

  • Maintain a Healthy Weight: Managing your weight goes hand in hand with managing diabetes. Extra body fat, especially around the waist, makes it harder for your body to use insulin effectively and is linked to higher dementia risk. If you’re overweight, even a modest weight loss can improve your blood sugar control. By eating better and moving more, you can often shed pounds and reduce insulin resistance, easing the strain on your brain. In fact, weight control is considered a first line of defense in type 2 diabetes management. Talk to your doctor or a nutritionist about setting a healthy weight goal. Remember to celebrate small victories – each pound lost is a win for both your diabetes and your cognitive health.

  • Manage Blood Pressure and Cholesterol: Diabetes often comes with high blood pressure or cholesterol, which can accelerate brain blood vessel damage. Make sure you’re checking your blood pressure regularly and taking steps to keep it in a healthy range (typically around 120/80). This might include dietary changes like reducing salt, taking prescribed medications, and, again, exercise. Similarly, have your cholesterol levels checked – if your LDL (“bad” cholesterol) is high, follow your doctor’s advice on diet or medication to lower it. Protecting your heart and blood vessels is essentially protecting your brain. As the American Heart Association puts it: “What’s good for the heart is good for the brain.”

  • Routine Health Checks: Don’t skip those doctor’s appointments. Regular check-ups can catch warning signs early – whether it’s prediabetes, rising blood pressure, or subtle cognitive changes. If you’re 45 or older (or earlier if you have risk factors), consider getting screened for type 2 diabetes. Early diagnosis and management of diabetes can stave off years of high blood sugar exposure to your brain. Likewise, if you already have diabetes, periodic cognitive screenings might be a good idea. Managing diabetes is a long game; your healthcare team can adjust your plan as your body and life change, ensuring your brain gets the best protection at every step.

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Moving Forward and Taking Control

Hearing that diabetes is linked to dementia might feel scary, but diabetes is highly treatable. By effectively managing diabetes, you can tilt the odds back in your favor. Many people with well-controlled diabetes never develop cognitive issues – especially if they combine medical treatment with a healthy lifestyle. In fact, experts note that treating conditions like diabetes is one of the key opportunities we have to reduce dementia risk at the population level. Every healthy meal you eat, every walk you take, every medication you remember to take is an investment in your brain health.

If you’ve been working hard to keep your blood sugar in check, take heart that you’re not just treating your diabetes – you’re also protecting your mind. And if you’re feeling overwhelmed or have slipped up in your management, know that it’s never too late to get back on track. Small improvements, like losing a few pounds or cutting down on sugary snacks, can start to pay dividends quickly. Your brain is remarkably resilient and will benefit from better blood sugar control at any age.

Type 2 diabetes management and dementia prevention go hand in hand. By keeping blood sugar and blood pressure in a healthy range, staying active, eating well, and working closely with your healthcare providers, you are stacking the odds in favor of a sharper, healthier brain in the years ahead. 

What’s Next

Diabetes management impacts so many aspects of your life - diet, exercise, heart health, doctor’s visits. It can quickly add up to feel overwhelming and trying to manage it all on your own can feel impossible. Science shows that despite our best intentions and most sincere dedication, it’s hard to make meaningful lifestyle changes and even harder to maintain them. We all know it’s hard to stick with a new diet and exercise routine. Despite our best intentions, priorities can change, life can get busy and healthy resolutions can be forgotten. Only 1 in every 8 or 9 people successfully complete self-guided health interventions. 

But you don’t have to figure this out on your own. What makes it easier? Many studies, including the U.S. POINTER trial, a study of lifestyle changes conducted by the Alzheimer’s Association, have shown that coaching support and structured intervention plans give people a statistically significant edge over those who are self-guided. 

Mindr is here to support you with all of these success boosting tools:

  • An easy to follow personalized plan that fits your life and addresses your most pressing risk factors

  • Daily guidance so you know exactly what to do each day

  • Frequent assessments and exercise tracking so you can see your progress

  • A human in the loop to support and encourage you

You wouldn’t still be reading this if having a healthy brain wasn’t important to you. The lifestyle changes that will get you there are within your reach. You have the will, we’ll show you the way - one day at a time. You can do this and we can help.

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References:

Jennifer Palmquist
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