Diabetes and neurodegeneration. The brain-body axis

The clinical boundary between metabolic disease and neurodegeneration is rapidly dissolving. In this live CDE Academy Journal Club session, we explore the emerging concept of “Type 3 Diabetes” (T3D), a term increasingly used to describe Alzheimer’s disease as a form of brain-specific insulin resistance.

Drawing on the systematic review by Atabi et al. (2025), we will examine the molecular crossroads where diabetes and dementia intersect. The evidence suggests that peripheral insulin resistance does not remain confined to the body but may impair the blood-brain barrier and disrupt neuronal insulin signalling. This metabolic dysfunction can contribute to reduced glucose utilisation within the brain, promoting the accumulation of amyloid-beta plaques, tau protein tangles, and chronic neuroinflammation—hallmarks of Alzheimer’s disease.

Complementing these mechanistic insights, Bloomgarden (2025) reviews the growing epidemiological evidence linking diabetes and cognitive decline. People living with diabetes face a significantly increased risk of both vascular dementia and Alzheimer’s disease, highlighting the importance of recognising brain health as a critical component of long-term diabetes care.

Encouragingly, emerging research suggests that certain metabolic therapies may offer benefits beyond glycaemic control. Novel evidence indicates that GLP-1 receptor agonists and SGLT2 inhibitors may possess neuroprotective properties, potentially helping to slow the progression of cognitive decline and opening new avenues for preventive care.

Join us as we unpack the science behind Type 3 Diabetes, explore the evolving relationship between diabetes and dementia, and discuss how healthcare professionals can integrate these insights into contemporary diabetes management. This session will challenge us to view cognitive health not as a separate concern, but as an essential endpoint in the comprehensive care of people living with diabetes.