Diabetes veterans may show ways to prevent complications

Mar 29, 2011

Over time, diabetes can wreak havoc on the body's eyes, cardiovascular system, kidneys and nerves. A major study by Joslin Diabetes Center researchers, however, has found that some people who have survived diabetes for many decades exhibit remarkably few complications—a discovery that points toward the presence of protective factors that guard against the disease's effects.

The scientists studied 351 participants in the Joslin 50-Year Medalist study, which examines people who have lived with type 1 for 50 years or more. Among this population, 43% are free from advanced diabetic eye complications, 87% from kidney disease, 39% from nerve disease and 52% from cardiovascular disease.

The surprising numbers of Medalists without complications "are strong evidence that protective molecular, physiologic or genetic mechanisms, in these fortunate individuals, fight against the toxic effects of high blood sugars over many decades," says Jennifer Sun, M.D., first author on the paper published in Diabetes Care.

As a group, the Joslin Medalists are very careful about controlling their blood glucose levels. However, within a reasonable range of glucose control, the study found that freedom from complications does not appear to correlate with how well these unique people controlled the blood sugar levels that go awry in diabetes. This conclusion differs from results shown in every other major recent study of diabetes management.

Clues to this protection may be found in analyses of a family of proteins called advanced glycation end products (AGEs), which are increased by high blood sugar levels. In the study, subjects who exhibited two specific AGEs were more than seven times as likely to have any complication. But this study also demonstrated for the first time that a combination of two other AGEs is associated with protection against eye disease.

Additionally, the researchers found a group of Medalists, followed at Joslin's Beetham Eye Institute, whose diabetic eye complications stabilized after 17 years at a mild stage rather than continuing to worsen as expected. This finding again indicated that protective factors are present in this group.

The Joslin Medalist study has gathered data on more than 600 people and is running a broad series of investigations into what guards so many of them from complications.

Moreover, these diabetes veterans can provide other important lessons, as Dr. Sun points out.

"Insights from the Medalist Study are great motivators for patients who have just been diagnosed with diabetes or are early in the disease, particularly younger kids and adolescents," she says. "We can tell these patients that we encourage them to control their blood sugars and get their recommended diabetes care, because they can live many decades with excellent vision and the chance to avoid other severe complications."

Explore further: Evidence-based recs issued for systemic care in psoriasis

Provided by Joslin Diabetes Center

not rated yet
add to favorites email to friend print save as pdf

Related Stories

Why do some diabetics escape complications?

Jan 21, 2011

Much research has been carried out on why diabetics develop complications. Now researchers are asking the question the other way around. They want to know why some diabetic patients do not develop complications. What is it ...

30-year study shows benefits of glucose control

Sep 11, 2008

(PhysOrg.com) -- A large-scale, 30-year study by Oxford University has shown improved blood glucose control in type 2 diabetes leads to greater benefits in the longer term. The findings, to be published in the New England Jo ...

Culprit found for increased stroke injury with diabetes

Jan 23, 2011

Strokes are a leading cause of mortality and adult disability. Those that involve intracerebral hemorrhage (bleeding in the brain) are especially deadly, and there are no effective treatments to control such bleeding. Moreover, ...

The Medical Minute: November is diabetes month

Nov 11, 2010

About 24 million adults in the U.S. have Diabetes. The U.S. Centers for Disease Control and Prevention recently released new projections that the incidence of diabetes in the U.S. will triple by 2050, meaning that 1 in 3 ...

Recommended for you

Evidence-based recs issued for systemic care in psoriasis

4 hours ago

(HealthDay)—For appropriately selected patients with psoriasis, combining biologics with other systemic treatments, including phototherapy, oral medications, or other biologic, may result in greater efficacy ...

Bacteria in caramel apples kills at least four in US

4 hours ago

A listeria outbreak believed to originate from commercially packaged caramel apples has killed at least four people in the United States and sickened 28 people since November, officials said Friday.

Steroid-based treatment may answer needs of pediatric EoE patients

5 hours ago

A new formulation of oral budesonide suspension, a steroid-based treatment, is safe and effective in treating pediatric patients with eosinophilic esophagitis (EoE), according to a new study in Clinical Gastroenterology and Hepatology, the official clinical practice journal ...

Discovery of genes that predispose a severe form of COPD

7 hours ago

A study by Ramcés Falfán-Valencia, researcher at the National Institute of Respiratory Diseases (INER), found that the mestizo Mexican population has a number of variations in certain genes that predispose ...

On the environmental trail of food pathogens

8 hours ago

Tracking one of the deadliest food contamination organisms through produce farms and natural environments alike, Cornell microbiologists are showing how to use big datasets to predict where the next outbreak could start.

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.