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Re: [IPp] Some Type 1 Diabetics Seem Shielded Against Complications

Hi Rachel,

Very interesting article.  One paragraph that leaped out at me was this one:

"More importantly, recent studies have provided evidence that diet is a
significant exogenous source of highly reactive AGEs. Food processing,
heating in particular, has a significant accelerating effect in the
generation of glyco- and lipoxidation products. Heat helps create tasteful
flavors that humans have learned to enjoy. In recent decades, food
manufacturers have been using this knowledge to boost the flavor of natural
foods by incorporating synthetic AGEs into foods. Consequently, the AGEs
content of the Western diet has increased vastly in the past 50 years, as
has the quantity of food consumed. "

Ouch.  Once again, we get back to diet.

I thought the article explained the general idea of AGEs pretty well.  What
kind of further information are you looking for?

Chris Brostrup-Jensen

On Thu, Mar 31, 2011 at 1:52 AM, Rachel A <email @ redacted> wrote:

> "The average A1C level in this group was 7.7 percent. A1C is a measure of
> blood sugar control over several months. People without diabetes have
> levels
> under 6 percent." - Good news! I try to keep Cole's A1c below 7.0 but we
> are
> usually in the low 7's... gotta love puberty! :(
> Can anyone explain AGE's to me? I could only find this about them:
> http://clinical.diabetesjournals.org/content/21/4/186.full "One potential
> reason is suggested by a certain combination of substances called advanced
> glycation end products (AGEs), which the study found were 7.2 times more
> common in people with complications. AGEs develop in the body after
> long-term exposure to high blood sugar levels."
> http://www.businessweek.com/lifestyle/content/healthday/651365.html
> <http://www.businessweek.com/lifestyle/content/healthday/651365.html>Some
> Type 1 Diabetics Seem Shielded Against ComplicationsIn one group that had
> diabetes for 50 years, many never developed expected problems, study finds
> *By Serena Gordon*
> *HealthDay Reporter*TUESDAY, March 29 (HealthDay News) -- While
> complications from type 1 diabetes are common, they aren't inevitable. New
> research suggests that some people with the disease apparently have an
> inherent protection against serious complications, such as eye, kidney and
> heart disease.[image: HealthDay/ScoutNews LLC] <http://www.healthday.com/>
> In a group of people who'd had type 1 diabetes for more than 50 years,
> nearly 43 percent remained free of serious eye disease, while about 87
> percent never developed kidney disease, nearly 40 percent were free of
> nerve
> damage and more than 50 percent were free of cardiovascular disease,
> according to the study.
> "We have identified a group of people who can clearly live well with
> diabetes for a long time," said the study's senior author, Dr. George King,
> chief scientific officer at the Joslin Diabetes Center in Boston. "Now,
> we're in the process of finding out why. In the meantime, if you have type
> 1
> diabetes, try to control your disease. The reason that most of them eluded
> the problem of complications is that they manage their disease pretty
> well,"
> said King.
> But, this study found that even in this group of people who -- on average
> --
> maintained good blood sugar control, some developed complications, while
> others appeared to have some sort of protection against them.
> Results of the study are published in the April issue of *Diabetes Care*.
> Almost 26 million Americans have diabetes, according to the U.S. Centers
> for
> Disease Control and Prevention (CDC). About 5 percent of those have type 1
> diabetes, the CDC estimates. Type 1 diabetes is an autoimmune disease in
> which the body's immune system mistakenly attacks the insulin-producing
> cells in the pancreas. Insulin is a hormone that's necessary for the body
> and brain to be able to use the sugars found in carbohydrates as fuel.
> People with type 1 diabetes must take replacement insulin, through
> injections or an insulin pump, all of their lives.
> Without insulin, or without enough insulin, the body can't use blood sugar
> for fuel, and the sugar builds up in the bloodstream. Long-term high blood
> sugar levels can cause a number of serious problems, including diabetic
> retinopathy in the eyes, kidney damage and possibly failure, nerve problems
> and heart disease.
> Previous research has shown that good control of blood sugar levels can
> help
> prevent these complications. But, it's difficult to keep blood sugar levels
> low without going too low (hypoglycemia), a potentially dangerous condition
> itself.
> For the current study, the researchers assessed complications in a group of
> 351 people with long-standing type 1 diabetes. These people were part of a
> group known as the diabetes "medalists." They've lived for more than 50
> years with type 1 diabetes, and were initially diagnosed at a time when
> good
> blood sugar control wasn't really possible because blood glucose meters and
> other technologies that help people live with diabetes today just weren't
> available then.
> The average A1C level in this group was 7.7 percent. A1C is a measure of
> blood sugar control over several months. People without diabetes have
> levels
> under 6 percent.
> Overall, King said, about 35 percent of the medalists didn't develop any
> serious problems related to their diabetes. "There's something in those 35
> percent that protects them from diabetic eye, kidney, nerve and heart
> disease," said King.
> And exactly what that protective mechanism might be isn't yet known. It's
> hard to create a control group for comparison to the unusual group of
> diabetes survivors, the study noted. In addition, the protective mechanism
> may be different for microvascular complications (such as kidney and eye
> disease) and macrovascular complications (such as heart disease), according
> to background material accompanying the study.
> One potential reason is suggested by a certain combination of substances
> called advanced glycation end products (AGEs), which the study found were
> 7.2 times more common in people with complications. AGEs develop in the
> body
> after long-term exposure to high blood sugar levels.
> This particular combination of AGEs (high plasma carboxyethyl-lysine and
> pentosidine) was linked to complications, but other AGE molecules appeared
> to have a protective effect -- an exciting finding the researchers said may
> lead to new biomarkers for protection against complications.
> And there may be other ways to keep the problematic AGEs under control.
> The author of an accompanying editorial, Dr. Aaron Vinik, noted that a
> receptor for AGE called sRAGE is lacking in people with complications.
> "When
> you have diabetes early on, you have about a 50 percent reduction in sRAGE.
> People who develop serious complications have an 85 percent reduction in
> sRAGE. So, the best predictor of longevity and freedom from complications
> may be a good sRAGE mechanism," explained Vinik, who is the director of the
> Eastern Virginia Medical School Strelitz Diabetes Center in Norfolk, Va.
> Vinick also pointed out that many of the drugs that are commonly prescribed
> today to help people with diabetes live longer and better lives -- such as
> ACE inhibitors to control their blood pressure and statins to control their
> cholesterol levels -- raise sRAGE levels.
> Both King and Vinik said that once researchers figure out exactly which
> substances are at play in those who are protected from diabetes
> complications, the findings could lead to ways to screen for those most at
> risk of complications, and potentially to a treatment that could help
> prevent complications.
> King said that while the researchers figure out how to better protect
> people
> with diabetes from complications, good blood sugar control remains the
> cornerstone of diabetes management. He added that the medalists as a group
> tended to be very proactive and involved in their diabetes care.
> "In general, the medalists control their disease rather than letting the
> disease affect their life patterns. This is a group of patients that
> manages
> things rather than let things manage them," said King
> Rachel - email @ redacted
> http://www.google.com/profiles/rachelandcole<
> http://www.google.com/profiles/rachelandcole#>
> https://www.facebook.com/AllBrightPhotography
> .
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