Alternative Fuels…for the Brain

Today’s front page carried a story by Lauran Neergaard of the AP entitled “Study to test theory linking Alzheimer’s with diabetes.” Ms. Neergaard’s article focuses on the recent announcement of a study of the diabetes drug Avandia (rosiglitazone) as a means of slowing the progression of Alzheimer’s disease.

I fully agree that the theory is provocative and, in my view, valid; however, it’s not all that new. There’s a pretty hefty body of evidence that’s accumulated over the last years suggesting that elevated blood sugar and insulin levels aren’t any better for the brain than they are for the body. What’s ‘new’ or more appropriately ‘news’ is that a giant of a drug company (GlaxoSmithKline) is ready to pony up big bucks basically to see if their horse in the diabetes drug sweepstakes can run on another track–ie among the drugs approved to treat Alzheimer’s.

Every drug maker that can get in has gotten into the diabetes sweepstakes, what with 16 million plus targets for their products–and more lining up every day to join their ranks. The link between diabetes and Alzheimer’s disease is, as Ms. Neergaard puts it

…a scary scenario: Alzheimer’s already is expected to skyrocket as the populations grays, rising from 4.5 million sufferers today to a staggering 14 million by 2050. If the new theory is right [and I strongly suspect it is–MDE] the nation’s current obesity-fueled epidemic of Type 2 diabetes could worsen that toll.

What the drug giants see is an enormous emerging new market for an already developed drug. The bottom-line plus for them is that there’s not much investment required (relatively speaking) to get the FDA nod for approved use for a second condition. At least, not nearly as much as to develop a whole new drug.

But I digress.

Unlike many diabetes drugs that try to spur the already-struggling pancreas to produce more insulin to overcome the body’s resistance to it, Avandia (rosiglitazone) acts to make the insulin work more effectively, by increasing the sensitivity of the receptors to the insulin signal. Of the two choices, Avandia and other drugs like it that spare the rod to the pancreas are a world better for diabetics.

But what’s that got to do with the brain?

The brain, under typical circumstances, uses glucose (blood sugar) as its primary fuel for energy production, because in most people there’s quite a lot of it around. In the insulin-resistant brain, however, while there may be lots of it around, it can’t be properly used for energy. The benefit derived from using a blood-sugar-lowering drug, whether Avandia or other drugs like it, to curb the memory deterioration of Alzheimer’s disease rests in improving insulin sensitivity and thereby improving the brain’s ability to use blood sugar as a fuel to produce energy.

But hold on a minute.

The brain doesn’t have to exclusively use blood sugar as a fuel. It can operate on an alternative energy source–ketones. Just as switching to cars that can run on alternative fuels–hydrogen, ethanol or biodiesel–will help to free us from our oil addiction (and from the grip of Middle East oil pushers) so switching the body to the use of alternative fuels can free us from the rising epidemics of diabetes and Alzheimer’s disease.

And while it may take years to get the nation switched over to alternative fuels, you can throw the metabolic switch almost immediately.

Within just days of adopting a sensible low carb diet, rich in good quality protein from meat, fish, poultry, eggs, and dairy, with plenty of essential fats, low sugar fresh fruits and low starch veggies, devoid or limited in added sugar and starches, blood sugar falls, insulin levels fall, insulin receptors begin to regain their sensitivity, glucose use improves, ketone production rises, the brain’s awash in fuels and all’s right with the world. (Please see caution below!**)

And that’s just in the short run. In the long run, maintaining blood sugar in a narrow, healthy range on a controlled-carb diet will reap benefits body wide–including the thinking machine inside your skull.

In our twenty something years of clinical practice, we’ve seen it over and over and over and over again.

Unfortunately, you won’t see Ms. Neergaard and her fellow inky wretches writing about it and, even more unfortunately, you probably won’t see any big companies (the government included) lining up to fund a big study to prove its effectiveness.

**Caution: Be forewarned that a low carb diet is a powerful tool to control blood sugar and blood pressure. People with diabetes, who take medication to control blood sugar should absolutely NOT begin a low carb diet without the guidance of a knowledgeable physician who can help to monitor blood sugar and/or blood pressure and reduce medications appropriately.

Please note: I reserve the right to delete comments that are offensive or off-topic.

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