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Your Health

Charlyn Fargo Ware: Understanding Type 3 Diabetes

You’ve probably heard of Type 1 diabetes (mainly in children) and Type 2 diabetes (which occurs later in life), but now there is a Type 3 diabetes. It’s the result of a link between diabetes and Alzheimer’s disease.

Type 1 occurs when the body’s pancreas is unable to make insulin. About 5 percent of diabetes cases are Type 1. It’s considered an autoimmune disease but has an unknown cause.

Type 2 diabetes occurs when the body doesn’t make enough insulin, and the insulin it makes doesn’t work properly. This insulin resistance leads to a buildup of blood sugar. Over time, especially if healthy blood sugar isn’t maintained, Type 2 diabetes develops.

Treatment of both types includes following a healthy eating plan and physical activity. Type 1 diabetes requires the addition of insulin. Insulin also may be required for Type 2.

Researchers have known for several years that being overweight and having Type 2 diabetes can increase the risk of developing Alzheimer’s disease, which is now defined as Type 3 diabetes.

Type 3 diabetes occurs when neurons in the brain become unable to respond to insulin, which is essential for basic tasks, including memory and learning. Some researchers believe insulin deficiency is central to the cognitive decline of Alzheimer’s disease.

This new Type 3 diabetes refers to a condition of having persistent insulin resistance in brain cells (neurons) to the point that it interferes with cognitive function. Neurons require glucose to work. When starved, not only do they decrease in activity and impair memory function, they also develop scar tissue and permanent cognitive decline similar to Alzheimer’s. High glucose levels in older adults have been linked to the development of dementia.

A new study from Guojun Bu, a neuroscientist and Mary Lowell Leary professor at the Mayo Clinic, found that the culprit is the variant of the Alzheimer’s gene known as APOE4. The team found that APOE4, which is present in approximately 20 percent of the general population and more than half of Alzheimer’s cases, is responsible for interrupting how the brain processes insulin.

Mice with the APOE4 gene showed insulin impairment, particularly in old age. Also, a high-fat diet could accelerate the process in middle-aged mice with the gene.

“The gene and the peripheral insulin resistance caused by the high-fat diet together induced insulin resistance in the brain,” said Bu, whose findings are published in the journal Neuron.

“This study has furthered our understanding of the gene that's the strongest genetic risk factor known for Alzheimer's disease,” he said, adding that, ultimately, the finding may personalize treatment for patients.

“For instance, an insulin nasal spray or a similar treatment may be significantly more helpful for patients who don't have the APOE4 gene. Patients who have the gene may need additional medications to help prevent cognitive decline.”

How can you prevent Type 3? The same way you prevent Type 2 — maintain a healthy blood glucose level, eat a healthy diet, exercise regularly, stay connected with friends and engage your brain.


Q: What are the reasons to use a smaller plate at meals and snacks?

A: A dietary tactic often recommended by dietitians is eating from a smaller surface. Think salad plate, not dinner plate. The idea behind this concept is fairly simple: We are attempting to “trick” our minds into thinking that we are getting more food when, in fact, the portion we are eating might be less than before.

Imagine serving up a balanced, portion-controlled meal on a large dinner plate; you might see a lot of “white space” around the plate. It may not seem like enough food, right? Now picture the exact same meal, but instead, imagine it on a smaller salad plate. The portions of food are now grouped closer together, perhaps even resembling heaping helpings, and there is minimal unused space on the plate. The same amount of food looks like more.

For some people, the visual impact of eating from a smaller (and more full-looking) plate can increase feelings of fullness and satisfaction with the meal and may, in turn, reduce the likelihood of returning for second and third helpings of a food.

The repeated impacts of this small change may aid one’s attempts at controlling food or energy intake (i.e., calorie intake) and possibly assist efforts in weight management.

— Environmental Nutrition

Banaa Nut Oatmeal Bars

Here’s a fun breakfast on the run — or a light dessert. These banana nut oatmeal bars are from the kitchens of Hy-Vee and a great way to use up ripe bananas.


» ½ cup pecans, chopped, plus extra for garnish

» 3 ripe medium bananas, mashed

» ¾ cup skim or almond milk

» 2 eggs

» ¼ cup coconut oil, melted

» ¼ pure maple syrup

» 2 teaspoons vanilla extract

» 2 cups rolled oats

» ¼ cup flaxseed meal

» 2 teaspoons ground cinnamon

» ¼ teaspoon nutmeg

» ¼ teaspoon ground cloves

» ¼ teaspoon salt


Preheat oven to 350 degrees. Lightly grease an 8-inch square baking dish with oil. In a skillet, add pecans; toast on medium-low heat until fragrant and lightly toasted. Allow to cool. In a large bowl, combine mashed bananas, milk, eggs, coconut oil, maple syrup and vanilla; mix together until smooth. Add in toasted pecans, rolled oats, flaxseed meal, cinnamon, nutmeg, cloves and salt; stir until well-combined. Spread oatmeal into prepared baking dish and bake for 20 to 25 minutes, or until set and light golden brown on top. Allow to cool in baking dish for at least 5 minutes before slicing. Serve warm with extra pecans and/or fresh fruit on top.


Serves 6

Per serving: 374 calories, 9 grams protein, 37 grams carbohydrates, 23 grams fat (9g sat), 62 milligrams cholesterol, 8g fiber, 47 milligrams sodium

— Charlyn Fargo Ware is a registered dietitian at Hy-Vee in Springfield, Ill., and the media representative for the Illinois Academy of Nutrition and Dietetics. Contact her at [email protected], or follow her on Twitter: @NutritionRd, or click here for additional columns. The opinions expressed are her own.

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