The Brain Hypometabolism Hypothesis Part 14: The Concept of Diabetes Type 3


In the course of looking for papers on the relationship between Insulin-Dependent Diabetes Mellitus (Type 1 Diabetes) I used the search term ‘insulin dependent diabetes dementia’ in Medline (PubMed). Interestingly this was converted into a combination of terms

“diabetes mellitus, type 1″[MeSH Terms] OR “type 1 diabetes mellitus”[All Fields] OR (“insulin”[All Fields] AND “dependent”[All Fields] AND “diabetes”[All Fields]) OR “insulin dependent diabetes”[All Fields]) AND (“dementia”[MeSH Terms] OR “dementia”[All Fields]

which retrieved 232 articles at the time of writing. While looking through these there were a number of interesting papers but slightly off the main topic of the Brain Hypometabolism Hypothesis (BHH). However one paper which was quite relevant is this one by Dr Suzanne de la Monte. The subject of the paper is Alzheimer’s Disease as Diabetes Type 3.

I became aware of this concept several years ago but to the best of my knowledge this subject has been on the periphery of research into Alzheimer’s Disease. The concept of Diabetes Type 3 is not widely accepted and looking at the ICD-11 Browser Beta (not final) version I couldn’t find any reference to this diagnosis as a specific category.

At this stage, this looks to be an emerging discussion but I am not clear on whether it will become an established diagnosis. It is still useful to know about this concept because even if it does not become established it involves various models of glucose metabolism in the brain.

The concept appears to date back to 2005 and from the paper above, the 2 initial papers are here and here. I will refer to this from here on in as the Type 3 Diabetes model (T3DM).


De la Monte SM. Type 3 Diabetes is Sporadic Alzheimer’s disease: Mini-Review. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology. 2014;24(12):1954-1960. doi:10.1016/j.euroneuro.2014.06.008.

Rivera EJ, Goldin A, Fulmer N, Tavares R, Wands JR, de la Monte SM.
Insulin and insulin-like growth factor expression and function deteriorate with progression of Alzheimer’s disease: link to brain reductions in acetylcholine. J Alzheimers Dis. 2005 Dec;8(3):247-68.

Steen E, Terry BM, Rivera EJ, Cannon JL, Neely TR, Tavares R, Xu XJ, Wands JR, de la Monte SM. Impaired insulin and insulin-like growth factor expression and signaling mechanisms in Alzheimer’s disease–is this type 3 diabetes? J Alzheimers Dis. 2005 Feb;7(1):63-80.

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