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
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