Brain Fog, Dementia and Alzheimer's with Diabetes

Diabetes has been known to influence the brain for more than 100 years. Sugar is the main source of energy for your brain and when your blood sugar is either low or high, brain fog can occur. Brain fog is more than just an annoyance. It presents as difficulty in concentrating, mental fatigue, problems with multitasking and fuzzy thinking.

It may also include decreased mental focus, low mental energy and forgetfulness. Most of your mental clarity is gone. Information takes longer to process, and you may even feel like you are in slow motion. You may struggle to find the right words at the right moment or the names of people you know well.

Diabetes and Brian Fog

Brain fog can be a symptom of diabetes, either fluctuations in your blood sugar that go too low or too high. Out of control high blood sugars eventually cause reduced and poor blood circulation. Your brain may not be capable of thinking clearly.

Also, if your blood sugar remains high, your serotonin (a neurotransmitter) levels increase and may cause nerve damage, inflammation and an inability to think straight. Insulin resistance from too little insulin or insulin not working correctly can affect your memory and verbal communication. When blood sugars go too low, multiple symptoms such as shaking and sweating occur along with the inability to concentrate, stay focused or think clearly.

Brain fog is a symptom, not a medical condition. It can be reversed if appropriately treated. Dementia and Alzheimer’s are actual medical conditions.

Brain fog can also be seen in these situations:

Systemic inflammation. This includes chronic diseases such as diabetes, vascular disease, PAD (peripheral artery disease) or heart disease.
Dietary sensitivities. Exposure to some foods can create an immune reaction. This is disruptive but not life threatening. Using an elimination diet called FODMAP can help. Reintroduction of each food at a later time is used to figure out which foods you cannot tolerate. Work with your physician or dietitian.
Immune disorders. Lupus, fibromyalgia, Sjogren’s are all immune disorders that create overactive inflammation in the body. This plays havoc on brain function and concentration and creates brain fog.

Other common causes of brain fog may include:

Dehydration
Menopause
Depression/Anxiety
Neurological diseases: Parkinson’s, stroke, multiple sclerosis
Mental or physical stress
Hormonal changes. Lower levels of hormones as we age (decreased testosterone in men and decreased estrogen and progesterone in women.)
Hypothyroidism
Acute or chronic infections
Poor eating habits, skipping meals, eliminating carbohydrates
Eating too much simple sugar, refined and processed carbohydrates
ADHD. A neurodevelopmental condition known as Attention Deficit Hyperactivity Disorder. It affects attention, impulse control and causes brain fog. Currently, it is said to be “due to genetics and the environment.”
Long haul COVID, especially in those who are unvaccinated
Untreated sleep apnea

What can you do to help eliminate brain fog?

These suggestions may be helpful to eliminate or reduce your chances of developing brain fog:

Using the supplements: Vitamins B6, B12 and folate, Vitamin D, Omega-3 and choline.
The B vitamins are found in meat, fish, poultry, starchy vegetables and fortified foods such as cereals. Folate is found in dark, leafy greens and fortified foods including enriched breads.
Vitamin D is found in salmon, egg yolks and fortified foods.
Omega 3 fatty acids are found in fatty fish, nuts and seeds.
Choline is a nutrient found in salmon, eggs, and poultry.

Other factors to reduce brain fog:

Get and keep your blood sugars in “target range” as much as possible. Having low or high blood sugar is dangerous for brain function. Monitor blood sugars with a continuous glucose meter (CGM) or use a blood glucose meter several times a day.
Sleep 7-9 hours. It’s not just the amount of time you sleep but also the quality of your sleep. You should wake up feeling “refreshed” not tired and irritable.
Move/exercise. Moving lowers insulin resistance and uses glucose as the energy source. It increases insulin sensitivity.
Take diabetes medications as prescribed.
Control your stress which raises blood sugars.
Get nutritional counseling as needed.
Get mental health counseling as needed.

What about Dementia and Alzheimer’s

“Dementia causes a progressive loss of a person’s thinking abilities.” Dementia is on a spectrum in a range of levels and different types. Actual changes in your brain structure appear “decades before symptoms start.” The main types of dementia include vascular dementia, Lewy body dementia, frontotemporal dementia and Alzheimer’s.

Alzheimer’s accounts for 60-80% of all dementia cases. The 2025 Alzheimer’s Disease Facts and Figures report says “Almost 80% of Americans want to know if they have Alzheimer’s before symptoms start. Up to 92% of Americans say they would be happy to take medications which would stop or slow the progression of Alzheimer’s before it affects their daily life.”

Over 7 million Americans are currently living with Alzheimer’s. In 2050, over 153 million people worldwide will be living with dementia. Several signs of Alzheimer’s include memory loss, losing or misplacing common objects like keys, mugs, glasses and placing them in uncommon areas like the refrigerator or the clothes dryer.

Other symptoms may include having difficulty working with money and numbers, being disoriented in your own home or neighborhood, difficulty in recognizing common people’s names and faces, using poor judgement, getting lost, taking a very long time to get something simple done, being impulsive, balance issues and having frequent mood and personality swings.

These signs and symptoms progress over time and you are then unable to complete your daily tasks. Many of these symptoms may mimic Parkinson’s disease or other neurological diseases, so testing should be done. There are “no current cures for dementia or Alzheimer’s” but there are treatments and lifestyle recommendations available.

Which tests are usually done to check for Dementia?

“Amyloid and tau plaques build up in the brain over many years.” Blood tests, urine tests, neurological tests and imaging tests are done to help with the diagnosis. Brain CT scans, brain MRIs and brain PET scans are used to rule out other medical conditions. A complete history and physical will be performed by an internist, a gerontologist or a neurologist.

“There is a brand-new FDA approved blood test to diagnosis Alzheimer’s. It is called LumipulseGpTau217/B-Amyloid 1-42 plasma ratio. It is less invasive and more economical compared to brain imaging studies. This blood test is intended for early diagnosis of amyloid brain plaques in adults 55 or older showing symptoms of Alzheimer’s.”

Until now, “There was no definitive diagnosis of Alzheimer’s disease until an autopsy was done.” There are several common screening tests and assessments done as well by a medical professional. The screening tests include the Mini-Mental State Exam (MMSE), the Mini Cog test, The Montreal Cognitive Assessment, the Alzheimer’s Disease Scale-Cognitive, among others.

Risk factors for Dementia include:

Age. This is the biggest risk factor for developing dementia. It is much more common in women since they generally live longer. “The risk doubles every 5 years after age 65. By 80 years of age, your risk for developing dementia climbs to 50%.
Genetics
Smoking
2nd hand smoke
Depression
Traumatic brain injury
Several concussions over a lifetime.
Diabetes. The most common types of dementia with diabetes are vascular dementia or Alzheimer’s.
Air pollution
Excessive alcohol consumption
Chronic systemic inflammation
Neuro-inflammation
Hearing loss-untreated
Visual loss-untreated
Hypertension
Low education status
Low vitamin D levels
High cholesterol
Sedentary lifestyle
Obesity
Gut/brain connection
Heavy cannabis use
Sleep problems
Social isolation or loneliness. Feelings of not belonging. You do not have meaningful or close relationships. This is different from “being alone.”

Some of these risk factors are modifiable while others are not.

How is Dementia medically treated?

There are medications available to treat dementia. At the present time, none of them cure the illness, but they may slow down the process, help with some symptoms and improve your quality of life.

Medications:

Cholinesterase inhibitors Aricept, Exelon, Razadyne. These are used to help improve alertness and thinking.
Memantine-Namenda. May help patients continue with their daily functions.
FDA approved IV infusion called Kisunla-Donanemab. It is a “monoclonal antibody which may slow Alzheimer’s.” It is given by a medical professional.