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Caution: Consult with your diabetes care team before starting a lower-carbohydrate meal plan. Diabetes medications such as insulin or oral drugs that stimulate insulin production (sulfonylureas or meglitinides) will need adjustment to prevent hypoglycemia (low blood glucose) when carbohydrate intake is decreased. In addition, blood glucose levels need to be checked more often.
Although the complications of diabetes are well known, scientists don’t fully understand the mechanisms that underlie them. However, a key to the mystery lies in what are known as advanced glycosylation end-products (AGEs).
In 1985, Anthony Cerami, PhD, identified a molecular structure he found in abundance in the blood of people with diabetes. He posited that these structures were responsible for the long-term complications of diabetes and named them advanced glycosylation end-products.
Since his pioneering work, other diabetes researchers have turned their focus on the biochemical effects of chronically elevated blood glucose, and it is now widely believed that AGEs are a major cause of the havoc wreaked by diabetes.
What the Research Shows
AGEs have been implicated in virtually every disease process associated both with aging and complications of diabetes. A 1991 study in the New England Journal of Medicine found that among diabetics with kidney disease, increasing concentrations of AGEs parallel the severity of their kidney function impairment.
Although not yet tested in humans, it appears that anti-AGE drugs may be useful in treating these various disease processes. In studies of animals with diabetes, a compound that chemically breaks apart AGE cross-links was able to slow or reverse disease processes in the heart, kidney and vascular system. The results of the study were published in a 2004 issue of the American Journal of Hypertension.
Steps to Keeping AGEs in Check
AGEs are one more important piece of the complex puzzle that is diabetes. They are also another clear and compelling reason to do everything you can to prevent diabetes, and if you have it, to keep your blood glucose levels under tight control. Regular monitoring of blood glucose, controlling your carbs and getting regular exercise can all play a role in better glycemic control.
What Are AGEs?
Over time, glucose molecules and protein molecules in the bloodstream attach, “gumming up” the protein molecules, resulting in something called cross-linking. When proteins become cross-linked, they stiffen and lose elasticity, causing—in the blood vessels, vital organs and skin—what we know as “aging.”
AGEs, the results of this cross-linking, are believed to damage tiny blood vessels in the eyes, kidneys and elsewhere and contribute to the narrowing and hardening of blood vessels that carry blood to and from the heart. The greatest concentrations of AGEs are found in older people and diabetics. While AGEs naturally accumulate over time, the process is accelerated in people with diabetes, who have chronically high levels of glucose.
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