toxic metabolites, key in diabetic complications
Glucose control may not be able to prevent complications associated with diabetes, according to a study presented yesterday Angelika Bierhausen at the XLVII Congress of the European Association for the Study of Diabetes, which is being held in Lisbon.
Recent studies have shown that, even in type 1 diabetes, glucosylated hemoglobin (HBA1C) and the duration of the disease can only explain 11 percent of the associated complications.In addition, several research in type 2 diabetes conclude that patients do not seem to benefit from greater glucose control, even if it approaches a normal HBA1C.In fact, there is a "diabetes paradox" explaining a subtype of patients with advanced phase complications.These have high levels of HBA1C even though they have normal oral glucose tolerance.The paradox confuses clinicians and patients and requires a pathophysiological explanation that could lead to a new therapeutic generation.
Glycosylated hemoglobin and the duration of the disease, even in type 1 diabetes, only explain 11 percent of complications
The correlation between HBA1C and nephropathy, neuropathy, retinopathy and cardiovascular disease points out that non -enzymatic glycation reactions and the accumulation of final products of advanced glycation could play a role in this matter.
However, Bierhaus has commented that this theory does not completely explain the paradox, since it is believed that the most important regulation factor of protein glycation is glucose."In spite of everything, decreasing it to normal levels is not the best way to fight against complications. However, there is a growing evidence that indicates that reactive metabolites accumulate even under conditions close to normoglycemia. And what is more, particularly in type 2, the signaling pathways for reactive oxygen species (ROS), reactive carbon species (RCS), reactive dicarbons and protein glycation are activated independently of glucose control. "