Key findings reported in the study abstract:
- People with diabetes tended to have hippocampal dysfunction, exhibited as memory decline, and
- Elevated blood glucose (sugar) was specifically implicated as the cause of this dysfunction.
- Using MRI, researchers actually observed reduced blood flow in key parts of the brains of people with elevated blood glucose;
- The effect (memory loss) can be observed even when levels of blood glucose are only moderately elevated;
- Glucose regulation worsens with age; and
- Though the age-related change may be subtle, the increase in blood glucose is still a risk.
- Physical exercise has been shown to improve glucose regulation;
- Even light physical activity can help; and
- Weight loss has also been shown to improve glucose regulation.
- It is possible that drugs which lower blood sugar may help, but those studies are not complete.
The study had nothing specifically to do with myeloma. However, those of us who are taking dexamethasone, prednisone, or another corticosteroid may have elevated blood sugar even though we don't have diabetes. We may be diabetics on DEX day. If so, the recent study suggests that we are also at risk for memory decline. What can we do?
- Exercise intentionally and regularly, and
- Maintain an ideal weight. Personally, Weight Watchers has worked for me.
- Eat well. Enjoy a plant-based diet, with grain and meat in moderation, and little or no empty carbohydrate. Vegetables, fruit, and nuts all contribute to our health, whereas soda pop and Twinkies detract from it.
- If you're on high-dose dexamethasone (40 mg/day four days in a row), please discuss this dosage with your doctor. A landmark study has shown that high-dose DEX results in a lower survival rate than reduced dosages;
- Get a blood glucose monitor and measure your glucose several times over one day to see how well it is regulated.
- I use the Accu-Chek Active meter, which is very inexpensive and widely available. I think I bought it in a Target store.
- My non-medical opinion: Most readings should be below 125 mg/dL, especially the first reading of the morning before eating, but readings in the hour or two after meals may go higher and readings on DEX day may be higher. Any spikes over about 180 are a matter of concern.
- Again, I'm no doctor. You should bring the results and discuss the issue of steroids and blood glucose with your prescribing oncologist. If you are not totally comfortable with the answer, discuss it also with your primary care physician, who deals with diabetics on a daily basis and may know more about blood glucose than your oncologist.
One point of that story is that the high blood glucose may have been harming me without any warning, because I didn't "feel" anything wrong. Another point is that we need to be in charge of our own health, and watch out especially for health issues that fall outside of the normal domain of our oncologists.
Be strong, be well.
Lunch: Leftover free-range no-hormone no-antibiotic bison potroast with onions, homemade organic pumpkin with pecans (crust-free pie), organic strawberries.