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Sundowning also tends to happen consistently around the same time of day, Elhelou says. “It often includes cognitive effects such as significant disorientation or impaired judgement,” she says.
The SCN is located in the hypothalamus and is associated with regulating sleep patterns by maintaining circadian rhythms, which are strongly associated with external light and dark cues. A disruption within the suprachiasmatic nucleus would seem to be an area that could cause the types of confusion that are seen in sundowning.
Management of the dawn phenomenon varies by patient and thus should be done with regular assistance from a patient's physician. Some treatment options include, but are not limited to, dietary modifications, increased exercise before breakfast and during the evening, and oral anti-hyperglycemic medications if a patient's HbA1c is > 7%.
Type 3 diabetes is a proposed pathological linkage between Alzheimer's disease and certain features of type 1 and type 2 diabetes. [1] Specifically, the term refers to a set of common biochemical and metabolic features seen in the brain in Alzheimer's disease, and in other tissues in diabetes; [1] [2] it may thus be considered a "brain-specific type of diabetes."
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Obesity has been found to contribute to approximately 55% of cases of type 2 diabetes; [10] chronic obesity leads to increased insulin resistance that can develop into type 2 diabetes, [11] most likely because adipose tissue (especially that in the abdomen around internal organs) is a source of several chemical signals, hormones and cytokines, to other tissues.
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