Since the impact of a disease like diabetes on the state of the body was already referred to as "accelerated aging," many of the studies focusing attention on glycation processes involved people with diabetes. We now know that the AGEs that are formed cause both direct and indirect damage to many cellular structures - by inducing oxidative stress and the phenomena of glycation and lipoxidation.
Glycation is a process that is closely associated with chronic hyperglycemia taking place primarily in diabetes, but also in the pre-diabetic state of abnormal fasting glucose and abnormal glucose tolerance. Elevated blood glucose levels lead to glycation, a process in which a glucose molecule attaches to a protein without enzymes. Glycation is a reaction between sugars and proteins that leads to the formation of so-called advanced glycation end products (AGEs). AGEs are harmful to our bodies because they can affect the structure and function of proteins.
It is AGEs that may be responsible for the development of diabetes complications, such as angiopathy (vascular damage : microangiopathy and macroangiopathy; neuropathy (nerve damage), and nephropathy (kidney damage), among others.
The process of glycation, occurs in both type 1 diabetes and type 2 diabetes. However, the mechanisms and factors leading to it may vary depending on the type of diabetes and, in addition, the presence of insulin resistance and hyperinsulinemia.
In type 1 diabetes, the process of glycation is mainly associated with high blood glucose levels due to a lack or insufficient production of insulin. As a result, elevated glucose levels can lead to increased protein glycation in the body of the affected individual. In addition, factors such as chronic inflammation, oxidative stress and excess free radicals can further accelerate the glycation process in type 1 diabetes.
In type 2 diabetes, on the other hand, the presence of insulin resistance and hyperinsulinemia (excess insulin) can affect the glycation process. Insulin resistance leads to inefficient use of insulin by our body's cells and tissues. This, in turn, causes blood glucose levels to rise. Excessive insulin, which we face in the case of hyperinsulinemia, can also contribute to exacerbating the glycation process.
Glycation occurs mainly in the circulatory system and mostly involves: glucose, fructose and galactose. Fructose appears to have about ten times more glycation activity than glucose, which is the body's main fuel. As it turns out, some glycation products are involved in many chronic age-related diseases, including cardiovascular disease (damage to vascular endothelium, fibrinogen, collagen) and Alzheimer's disease (amyloid proteins are byproducts of reactions leading to AGEs). Long-lived cells (such as nerves and various types of brain nerve cells), read so-called persistent proteins (such as lens and corneal crystallins) and DNA can undergo significant glycation over time.
Glycation damage leads to stiffening of collagen in blood vessel walls, which leads to higher blood pressure, and is ultimately the cause of hypertension in diabetes. Glycations also cause collagen in blood vessel walls to weaken, which can lead to microaneurysms or aneurysms. In the case of the brain, it can lead to the development of strokes.
How soon after the diagnosis of diabetes does the glycation process begin?
It should be noted that the glycation process begins long before diabetes is diagnosed. In fact, it already begins when blood glucose levels are elevated for an extended period of time, even if the person in whom the process occurs has not yet been diagnosed with diabetes. This means, unfortunately, that the glycation process may already be very advanced when type 2 diabetes is officially diagnosed.
Understanding glycation and its effects is crucial to understanding diabetes and its associated complications. The efforts that diabetologists make with their patients to reduce the severity of glycation can help manage diabetes and reduce the risk of complications. Through the right choice of medications, a proper diet and regular exercise, it is much easier to maintain adequate blood glucose levels and therefore minimize or at least partially inhibit glycation processes.
It is for this reason that both people with diagnosed diabetes and those with "just" pre-diabetes (abnormal fasting glucose or abnormal glucose tolerance) should pay close attention to blood glucose levels and take appropriate steps to control them. This will minimize the risk of glycation and its harmful effects on the patient's body. Glycation is a complex biochemical process, but understanding it can lead to better diabetes control and improved quality of life.
How fast does glycation occur?
The speed of the glycation process depends on the concentration of glucose in the blood. The higher the blood glucose concentration, the faster the glycation process. It can usually take several weeks to several months, depending on blood glucose concentration.
Can we stop the glycation process?
To inhibit the glycation process and reduce the formation of advanced glycation products, several measures can be taken, which include:
- Blood glucose control: Maintaining adequate glucose concentrations is key to reducing the glycation process. In diabetes, this requires monitoring of blood sugar levels and regular use of prescribed insulin or anti-diabetic drug therapy.
- Healthy diet: A low glycemic index diet, rich in vegetables, appropriate fruits, whole grains and healthy fats, can help keep blood glucose stable and reduce glycation.
- Antioxidants: Antioxidants such as vitamin C, E, beta-carotene and flavonoids can help protect the body from oxidative stress and reduce the glycation process.
- Healthy lifestyle: Avoiding smoking, limiting alcohol consumption, regular physical activity and weight control are important in reducing the glycation process.
Often these more inquisitive patients ask whether supplements can help inhibit the glycation process?
Well, as it seems, supplements such as benfotiamine (a lipophilic form of thiamine, or vitamin B1), alpha-lipoic acid, vitamins C and E, carnosine and green tea extract can be useful and slow down the dynamics of the glycation process. Most of the supplements mentioned act as antioxidants, helping to protect proteins from damage caused by the glycation process. However, it is important to remember that supplements can never replace a proper diet and regular physical activity. In addition, they should properly be used only after prior consultation with a doctor or certified nutritionist.
In summary, the glycation process occurs in both type 1 and type 2 diabetes, but the factors leading to this process may differ. The glycation process produces advanced glycation products that can lead to diabetic complications. Reducing the glycation process depends largely on ourselves and the treatment selected for us by our doctors, Proper control to inhibit the accelerated aging process in diabetes requires primarily glucose control, a healthy diet, antioxidants, a healthy lifestyle and possibly drug therapy.
Dr. Marek Derkacz, MBA
