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Remembering Kevin Moore

Treating ‘Type 3 Diabetes’ Of The Brain With Insulin And Drugs–Have Researchers Gone Completely Crazy?


Dr. William Klein is so inclined to give Alzheimer’s patients insulin injections

After several years of studying and observing people involved in the world of diet, nutrition, and health, I’ve come to one grim conclusion–the more we learn about what truly makes us sick and unhealthy, the less willing we are to apply those lessons to the very people who would stand to benefit from them the most.

The latest example of this all-too-common occurrence comes to us today courtesy of a Reuters new story about a new study that identifies a relatively new form of diabetes of the brain known as “Type 3 diabetes.” I first blogged about this term in September 2007 when I interviewed low-carb neurosurgeon Dr. Larry McCleary about his book called The Brain Trust Program. But as you will quickly see, the conclusion of the researchers in this study is FAR different from what Dr. McCleary would ever advocate (I’ll be featuring an engaging interview with him on February 19, 2009 at my podcast show).

According to the study published in the February 2009 of the Proceedings of the National Academy of Sciences, lead researcher Dr. William L. Klein, Professor of Neurobiology & Physiology and of Neurology at the Evanston, IL-based Northwestern University, and his team concluded that insulin protects the brain from toxic proteins that lead to Alzheimer’s disease which they acknowledge is indeed this “Type 3 diabetes” of the brain. They added that treating the neurologically-diseased and Alzheimer’s patients with insulin and a diabetic prescription medication called Avandia can improve brain function and should be used as a routine treatment option for people suffering from these conditions.

Whoa whoa whoa, wait just a minute! Why would we want to be pumping insulin and diabetes drugs into people who dealing with a terrible disease like Alzheimer’s when previous research from 2006 has already shown changing to a low-carbohydrate nutritional approach gives the brain the preferred fuel source it craves–ketone bodies–to function at optimal levels and effectively reverse the impact of Alzheimer’s disease. And we know from this research released in 2005 that the use of a hyperketogenic diet of a very high-fat, very low-carb nutritional intake to effectively treat and cure conditions such as Parkinson’s, Alzheimer’s and Lou Gehrig’s disease has shown great results to those who have tried it.

Plus, we can thank Swedish researchers who have already demonstrated to us that high blood sugar levels and Alzheimer’s disease are indelibly connected. So, wouldn’t it stand to reason that controlling the blood glucose in the body would help to manage diseases of the brain like Alzheimer’s? Sure it would. But rather than attempting to use dietary treatment options like an aggressive low-carb, high-fat diet, researchers like Dr. Klein insist on injecting insulin and drugs into Alzheimer patients instead. Why would you do that other than to line the pockets of the pharmaceutical companies like GlaxoSmithKline that stand to profit to the tune of billions of dollars marketing their drug to the estimated 73 million pre-diabetic and diabetic patients in the United States alone?

In fact, according to the NIH-related National Institute on Aging web site, research is already underway looking at the impact of an insulin nasal spray on memory for patients with Alzheimer’s disease. Their thinking is to squirt the insulin directly into the brain through the nose to avoid the hypoglycemic response that would happen if injected in the traditional way into the arm. But like Type 2 diabetics who are told to keep eating sugar and carbohydrates as long as you just give yourself insulin shots, this is the exact WRONG approach to helping people dealing with Type 3 diabetes–Alzheimer’s disease.

Why not encourage carbohydrate-restriction to these patients? Then the need for insulin and diabetes medications like Avandia becomes irrelevant because blood sugar and insulin are controlled naturally through their diet and thus treated just as effectively if not better. There’s only one teeny tiny little problem with this solution to those who provide health care for these patients: nobody makes any money off of treating Alzheimer’s sufferers this way. I hate to be cynical, but it’s hard not to be when you see this same scenario play itself out over and over again after a phenomenal study comes out clearly identifying a problem that could be solved with livin’ la vida low-carb. And yet a drug or other revenue-producing medical substance like insulin is pushed on to people as the “best” and many times the “only” treatment for dealing with a preventable disease.

BALONEY! Listen up everyone because I want you to hear me loud and clear. Whenever you hear from a researcher or doctor that the ONLY way you can treat a disease is through medication or surgery as your first choice, then you should immediately question it. From all I’ve seen in just the few short years of looking at this subject of health as an educated layperson, there are almost always natural ways to manage health conditions–especially with the proper diet. Most of your health centers around metabolic issues whether the medical world will ever acknowledge that or not. It’s what makes the measly one or two weeks of nutrition courses offered to medical school students so woefully inadequate for dealing with the real world cases they’ll encounter with their patients day in and day out.

As harmful as we know carbohydrates can be in the body of someone who is insulin resistant or dealing with other high blood sugar/high insulin issues like diabetes and metabolic syndrome, the first course of action that SHOULD be taken is placing those particular patients on a high-fat, low-carb diet immediately. If after 90 days of this kind of treatment there is no improvement, then possibly looking at prescription drugs and/or insulin could become a part of the conversation. But this should ONLY be as a last resort when the diet has failed to correct the issues.

But from what I’ve seen both scientifically in the literature as well as from anecdotal stories of the changed lives of real people here at my blog, the diet approach will NOT fail if it is given a fair chance to work. And practitioners don’t need to try to encourage their patients to sneak in so-called “healthy” whole grains or low-fat foods to screw with the results. Give patients Dr. Atkins’ New Diet Revolution to read and then encourage them to soak it all up on their way to getting better for good.

Is it REALLY too much to ask for diet to be the first consideration for a period of time before resorting to more risky approaches to treating preventable diseases? I don’t think so and neither do most thinking people. We need to end this pill-popping madness and stop encouraging the production of more and more drugs to treat every disease known to mankind! Gimme a break people. Livin’ la vida low-carb might not cure every ailment–but it sure hits a lot of them.

You can e-mail Dr. William L. Klein about his study and ask him about why they didn’t consider carbohydrate-restriction in their conclusions regarding Alzheimer’s patients by writing to wklein@northwestern.edu.

2-7-09 UPDATE: I asked Dr. Larry McCleary to respond with his thoughts on this study which I think you’ll find to be very interesting…

Hi Jimmy,

This is an interesting study.

To summarize: The researchers were studying nerve cells in tissue culture. This means they were not in a brain, but had been placed in a growth medium (like what they do to grow bacteria on a petrie dish). The cells came from the hippocampus (one of the primary memory centers in the brain).

They looked at the neurons for evidence of Alzheimer disease type of pathology (such as build up of amyloid beta pathology) in the untreated neurons. They then added insulin to some similar nerve cell cultures to see what difference it made. When this was done, they noted a marked decrease in amyloid beta pathology (which is a positive change). They did the same thing with Avandia (a type II diabetes medication that increases the response to insulin, or enhances insulin sensitivity) — basically sprinkling it in with the nerve cells. They saw similar benefits in the nerve cells — those being less amyloid beta pathology.

The take home message from these studies is that somehow both the addition of insulin or Avandia did something beneficial for the nerve cells.

Amyloid beta does several bad things to nerve cells. By binding to specific receptors (binding sites located on the surface of the nerve cells) it causes oxidation and decreases neuroplasticity — the ability of nerve cells to make connections, or synapses, with other neurons. It can even kill nerve cells. These findings decrease memory function. Both insulin and Avandia applied directly to the neurons markedly decreased these findings.

The interpretation of these observations from a clinical perspective is as follows:

1) Enhanced insulin signaling in the brain is good for brain cell function and metabolism. Insulin signaling can be enhanced directly be applying more insulin to the nerve cells, or by making the nerve cells more sensitive to the insulin that is already present (as demonstrated by the beneficial results obtained when Avandia was added).

These findings have been applied to humans by administering insulin intra-nasally to humans with mild Alzheimer disease. The patients showed improved memory when this was done.

The importance of these observations for someone with Alzheimer disease (a disorder with no current cure) is as follows: that insulin taken intra-nasally may temporarily improve function in a condition with no cure. Avandia may be slightly helpful in this context as well.

To fully understand what happens in the brain damaged by Alzheimer disease, you need to know that insulin signaling in the brain declines. (This is another way of saying that the brain becomes insulin resistant — just what happens to the body when diabetes develops.) That leads to the formation of amyloid beta pathology and nerve cell and synaptic loss.

From a health perspective, it makes the most sense to make lifestyle choices that maximize total body insulin sensitivity. That means eating right, exercising regularly and avoiding stress — to name a few things. They represent the best way to be healthy from both a brain and body perspective. When this is done, insulin signaling in the brain improves (and injecting insulin intra-nasally is not needed.)

As we become insulin resistant, the levels of insulin rise in our bloodstream. Since insulin in the brain comes from the blood, one might think that brain insulin levels would rise in tandem with blood insulin levels. THIS IS NOT THE CASE! When insulin levels in the blood rise, insulin levels in the brain actually fall to below normal levels. This occurs partially because the brain transports much less insulin from the blood into the brain cavity. Lower brain insulin levels mean less robust insulin signaling and result in enhanced amyloid beta pathology and nerve cell loss. The best way to prevent this is by keeping blood insulin levels low and this is best done by eating reasonably — meaning avoiding excess calories and excess carbs.

While Dr. G. Pasinetti has done work showing calorie and carb restriction helps prevent AD from developing and improves function, there are some individuals in such advanced states of pathology that these interventions don’t work and it is only for those individuals that intra-nasal insulin and so forth might be considered.

The best approach is to eat right and prevent the situation from developing in the first place.

So, from my perspective, the research studies done by Dr. Klein SUPPORT what you have been saying all along. That is, that eating right is healthy for the body and brain by maintaining insulin sensitivity in both. His studies merely document that by demonstrating that good insulin signaling in the brain is beneficial for brain health.

I hope this helps.

Thanks,

Dr. Larry McCleary

  • Unbelievable…

    or is it…

    this past weekend we had our first Low Carb gathering and one of the people who was invited told us that she is a Type 1 diabetic and that her doctor has recently decided to take her off her insulin medication with immediate effect and prescribed cold corn porridge to her to eat 3 times a day as cure. So off goes the insulin, on goes the carb-load ! Now isn’t that beautiful !

  • Mike G

    Jimmy,
    1. You can’t give Alzheimer’s patients Dr Atkins’ book and expect them to understand it. If they already have the disease, they won’t even be able to read and remember a comic book. You would have to convince the patient’s representative to go against established practice.
    2. Also, a doctor can’t simply do what he thinks is logical if it goes against mainstream medical practice in our litigious society. Lawsuits are a real and present danger to any non-mainstream MD.

    Mike, obviously the person caring for the Alzheimer’s patient would be the one to implement the low-carb strategy. That really goes without saying. As for the threat of lawsuits for doctors, I understand that. But with solid science on the side of the truth about livin’ la vida low-carb, it would never hold up in court.

    –Jimmy

  • RandoMan

    Jimmy,
    I think you might be missing the point. The point is not insulin flooding per se, but maintaining insulin-sensitivity. The more insulin sensitive you are (i.e. less diabetic), the more effective insulin functions. And we all know that low-carb is the best way to improve insulin sensitivity. Therefore, their study actually demonstrates that low-carb is the best way to prevent/reverse Alzheimer’s disease –> http://seattlepi.nwsource.com/health/397842_stayyou30.html

    Unless that fact is explicitly stated in the study conclusions by the researchers, then NOBODY is gonna infer that they need to be eating a low-carb diet. All I see is their promotion of insulin and diabetes drugs to treat Alzheimer’s…we all know that is NOT a permanent solution to controlling diabetes–Type 2 or Type 3.

    –Jimmy

  • Sharon Drosehn

    Even if you convinced relatives to try this, the “patient” would have to also be willing to eat very differently than they ever have. If the patient is in a nursing home, you’d have to convince doctors, the staff, the relatives, etc. to go along with it. And with all the ignorance on the subject and everybody being terrified of fat….
    I think what you’re doing now, Jimmy-informing people of studies that show it could help to go very high-fat, low carb is a great service for middle-aged people who want to avoid mind problems as they age-especially those of us who are pre-diabetic.

  • RandoMan

    So it could be inferred that insulin-resistant diabetes patients need to compensate low insulin sensitivity with higher dose of insulin.. of course, low-carbing would be a better long term solution.

  • Hi Jimmy – this is sad to read, but no great surprise when you consider that the medical establishment have been progressively destroying the pancreas of diabetics for decades by encouraging them to pump themselves full of insulin instead of avoiding the food that creates the insulin requirement in the first place.

  • Cindy

    The docs probably think the patients can’t or won’t change their diet so as to control insulin.

    Like when you went on Metformin, when there were still diet changes you could have done before going on the meds, as I recall. Such as 3 regular meals and no industrial sweets.

    People get scared and desperate and think the pill is a help, when really all it does is push the real solution farther out because the patient doesn’t learn how to eat to keep insulin down for THEIR body.

    Actually, in my case I exhausted all dietary changes I could make and my low-carb doctor felt that adding Metformin would help. And it has. But it along with insulin and high-carb diet would NOT have been the solution if I were diabetic.

    –Jimmy

  • Dan (aka Renegadediabetic)

    Stupid. $$$$$$ trumps science again.

  • RandoMan

    Jimmy, I think it is very easy to see that this study actually bolsters the case for low-carb diet.

    Just reading the following Reuter’s excerpt:

    “In Type 1 diabetes, your pancreas isn’t making insulin. In Type 2 diabetes, your tissues are insensitive to insulin because of problems in the insulin receptor. Type 3 is where that insulin receptor problem is localized in the brain,” Klein said in a telephone interview.

    “The effect was amplified when they added the drug rosiglitazone, which increases insulin sensitivity.”

    So I think the study got the cause-and-effect right (the less sensitive to insulin the more age-related Alzheimer risk). It is only in the remedy the study got it completely wrong since flooding with more insulin will only decrease insulin sensitivity further in the long term. (Of course these people are always short term and in addition have drugs to sell.)

    And the REMEDY is the most important part, RandoMan. It does no good to identify a problem if the best solution for treating it is all but ignored.

    –Jimmy

  • Cora Salvino

    I agree with the people who say that this study actually supports low carb for Alzheimer’s prevention. This is a tissue culture study. They were just trying to prove that insulin prevents the changes associated with Alzheimer’s. This really says nothing about treatment since neither insulin nor diabetes drugs would cross the blood-brain barrier. The best way to prevent the problem would be maintaining sensitivity in the insulin receptors in the brain. The best way to do that is with a low carb diet.

    No doubt that it does if we put two and two together for people. But with headlines blaring “Insulin and drugs best treatment for Alzheimer’s disease,” the first thing that crosses people’s minds isn’t livin’ la vida low-carb sadly. This is exactly what happens to Type 2 diabetics, too, so we should not be surprised. That’s why we must continue to educate people about low-carb and why it will best manage their health.

    –Jimmy

  • If we were telling people about the adverse effects of Amphetamine or Methamphetamine or Speed or Cocaine they would readily agree. — Unfortunately they are unable to equate the stimulant drug, sugar and starch and hybrid carbohydrates with this same effect!

  • Ted Hutchinson

    http://www.drmccleary.com/2009/02/09/LoCarbAndTheBrain.aspx
    Dr Larry McCleary has a blog on this research.
    You will note he places the emphasis on
    “there are other ways to enhance brain insulin signaling, which include calorie and carbohydrate restriction. These interventions were studied in mice who were placed on low calorie/low carb diets. ”
    and
    ” modification of lifestyle factors such as nutrition may prove crucial to Alzheimer’s disease management.”

    Right, Ted, I asked Dr. McCleary to respond to this. I look forward to sharing my podcast interview with him this Thursday. Check it out!

    –Jimmy

  • Fascinating that one of the big factors is insulin resistance in the brain.

    Dr. McCleary may have a point about getting insulin into the brain if insulin resistance their manifests as decreasing transport accross the blood-brain barrier. At that point is it possible to improve insulin sensitivty and/or get more into the brain without drugs?