Diabetes, Alzheimer’s, and Brain Health: Why Representation in Neurosurgery Matters

As we honor Diabetes and Alzheimer’s Awareness Month, let’s take a closer look at how these conditions are more connected than most realize—particularly through their impact on the brain and the role neurosurgeons play. When most people think about diabetes, the brain isn’t the first organ that comes to mind. Blood sugar, circulation, or vision issues are usually top of mind. Likewise, when Alzheimer’s enters the conversation, we tend to think about memory loss and aging. Rarely do we connect the two — but the truth is, both conditions deeply affect brain health, and both disproportionately impact Black and Brown communities.

And while diabetes and Alzheimer’s are two separate health issues with distinct awareness efforts, they intersect in meaningful ways when it comes to prevention, neurological care, and long-term outcomes — especially in underrepresented populations.

Diabetes: A Metabolic Condition With Neurological Consequences

Diabetes doesn’t just affect blood sugar regulation — it creates a chain reaction in the body that can accelerate brain aging and damage the brain’s microvascular system, the same tiny vessels neurosurgeons work to protect during stroke treatment and other interventions. Research shows that people with diabetes are 3–4× more likely to experience ischemic stroke, particularly before age 65, and the risks are even higher in Black communities.

• 38.4 million people in the U.S. live with diabetes, and 8.7 million of them are undiagnosed.

• Black adults are 1.24× more likely to be diagnosed, and experience higher rates of stroke, amputations, and complications.

• Among Americans with diabetes, vascular damage and inflammation can accelerate neurological decline — often before symptoms are recognized.

This means that for many, the first time brain-related complications are addressed is after a crisis has already begun.

Alzheimer’s: A Neurodegenerative Disease With Deep Community Impact

Unlike diabetes, Alzheimer’s is not metabolic — it is a degenerative disease that gradually affects memory and cognition. However, risk factors like diabetes, high blood pressure, and obesity contribute significantly to the likelihood of developing Alzheimer’s, which may help explain why Black Americans face higher rates of the disease.

• Approximately 21.3% of Black adults aged 70+ live with Alzheimer’s or dementia, nearly twice the rate of White older adults.

• Black individuals are often diagnosed later or inaccurately, in part because many diagnostic tools were not validated across diverse populations.

• Care is often costlier and starts later — meaning opportunities for prevention and treatment may be missed.

The longer the gap between symptom onset and diagnosis, the more advanced the brain declines by the time surgical or neurological intervention becomes an option.

Where Neurosurgery Fits In — and Why Representation Matters

Neurosurgeons frequently meet these patients after advanced stroke, brain injury, or late-stage cognitive decline — when preventive opportunities have passed. But meaningful change begins before the operating room.

We need to support the advocacy of awareness from a standpoint that they affect brain health. Furthermore, there is a clear disparity in outcomes for both conditions within black and brown communites. There is no established neurosurgical intervention for Alzheimer's but there are innovative treatments that are being studied to treat cognitive decline.  

So what can we do?

• Earlier screenings and culturally relevant prevention efforts

• Stronger trust between providers and historically underserved communities

• Improved accuracy of neurological diagnostics

• Advocacy for inclusive clinical research and education

Education ensures prevention. Let’s raise awareness, promote prevention, and expand brain health education rooted in equity and representation.

Sources: 

• NIH - Ischemic Stroke Mortality in Type 2 Diabetes in the U.S.: National Trends and Demographic Disparities From 1999 to 2019

• CDC - National Diabetes Statistics Report

• American Stroke Association - Let’s Talk About Black Americans and Stroke

• NIH - Diabetes-related cognitive impairment: Mechanisms, symptoms, and treatments

• Alzheimer's Society - Obesity and dementia risk

• Alzheimer's Association - Black Americans and Alzheimer's

• Research Gate - Millions of black people affected by racial bias in health-care algorithms

• International Journal for Health Equity - Barriers to health equity in the United States of America: can they be overcome?