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

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 p
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