Navigation Links
Some Type 1 Diabetics Seem Shielded Against Complications
Date:3/30/2011

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.

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.

More information

Learn more about type 1 diabetes and how to manage it from the U.S. National Library of Medicine.

SOURCES: George L. King, M.D., chief scientific officer, Joslin Diabetes Center, and professor of medicine, Harvard Medical School, Boston; Aaron Vinik, M.D., director, Eastern Virginia Medical School Strelitz Diabetes Center, Norfolk, Va.; April 2011, Diabetes Care


'/>"/>
Copyright©2010 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Diabetics Twice as Likely to Have Hearing Loss; Florida HearUSA Centers to Offer Free Hearing Screening and Diabetes Video in March
2. Diabetics Twice as Likely to Have Hearing Loss; Massachusetts HearUSA Centers to Offer Free Hearing Screening and Diabetes Video in March
3. Intense Cholesterol, Blood Pressure Therapies Dont Help Type 2 Diabetics
4. Prodigy Re-Launches Syringe-Filling System for Blind and Low-Vision Diabetics
5. Accepting Help Improves Survival Among Diabetics
6. Diabetics Face Higher Death Risk After Cancer Surgery
7. Women, Diabetics Fall Fast Into Medicare Doughnut Hole
8. Discovery could help diabetics and others with slow-to-heal wounds
9. High-Dose Vitamin B Risky for Diabetics With Kidney Disease
10. Tight Blood Sugar Control May Not Harm Diabetics
11. Healthy Pre-Diabetics Still Face Heart Disease Threat
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
 Some Type 1 Diabetics Seem Shielded Against Complications
(Date:5/26/2017)... ... 2017 , ... After raising nearly $30,000 on Kickstarter , about three-times ... at a discounted crowdfunding price on Indiegogo . , “Along with creating an ... to bring a fidget toy to the market that was made of superior quality ...
(Date:5/26/2017)... ... May 26, 2017 , ... “When the Stars Lead Home”: a poignant ... of published author Laura Weigel Douglas, an avid reader who lives in the Pacific ... sometimes feels like Green Hills Adventure Camp. She couldn’t be more grateful. , Twelve-year ...
(Date:5/26/2017)... (PRWEB) , ... May 26, 2017 , ... Water damage ... Lee, New Jersey School District had left education officials with a number of critical ... replacement of the flooring had to be accomplished with little or no disruption to ...
(Date:5/24/2017)... ... 24, 2017 , ... NucleusHealth ™, advancing clinical practice ... Food and Drug Administration (FDA) 510(k) clearance for its Nucleus.io ... for medical image management. At the core is patented streaming technology that provides ...
(Date:5/24/2017)... ... May 24, 2017 , ... Myers Jackson is well ... the ability to sell luxury homes anywhere on the planet. The luxury home market ... from Hattiesburg to Houston city-scapes. A quick search of “11 Spyglass Hill Auction will ...
Breaking Medicine News(10 mins):
(Date:5/9/2017)... 9, 2017 Zimmer Biomet Holdings, Inc. (NYSE ... today announced it has earned a spot on ... The Company was ranked among 500 U.S. employers as ... Healthcare Equipment and Services. The annual ... anonymous, independent survey of over 30,000 employees across 25 ...
(Date:5/9/2017)... 2017  Semler Scientific, Inc. (OTCQB: SMLR), an ... improve the clinical effectiveness and efficiency of healthcare ... quarter ended March 31, 2017. ... to identify when preventive care options are appropriate, ... heart attacks or strokes occur," said Doug ...
(Date:5/6/2017)... , May 5, 2017   Provista , a proven ... than 200,000 customers, today announced Jim Cunniff as ... of executive and business experience to Provista, including most recently ... in California . He assumed his new ... is a great fit for Provista," says Jody Hatcher ...
Breaking Medicine Technology: