New Test Predicts Damage from Diabetes

New test has the potential to be as significant to health care as measuring cholesterol levels. Merlin Thomas, of Melbourne’s Baker Heart Research Institute, is in the process of refining a blood test aimed at predicting the likelihood of organ damage in those with elevated blood-sugar levels, particularly patients with diabetes.

The test is based on determining the level of advanced glycation end-products (AGEs) in the body, which form when sugar damages proteins.

Associate Professor Thomas says the process is much the same as what happens when brown sugar and butter are mixed together to make caramel but when it occurs in the body, the result is nowhere near as sweet.

AGEs are known to be involved in hardening of the arteries, Alzheimer’s disease, ageing of the skin and kidney disease.
Basically, they contribute to the ageing process, slowly "caramelizing" us through time, Prof Thomas says. They cause tissue to become stiffer – the same process as what makes mutton tougher than lamb. Although AGEs are present in everybody, they accumulate much more quickly when sugar concentration is high, one of the reasons why strong sugar control is so important for those with diabetes.

The process means people with diabetes are at increased risk of heart attacks, strokes, kidney failure and blindness at an earlier age.

Already Baker scientists have successfully trialed a "crude" test for AGEs on more than 1,000 patients with diabetes, finding it to be an accurate predictor of the likelihood of complications.

But Prof Thomas said much more work needed to be done before general practitioners could use it." We need to refine it, make it even more precise," he said."

Prof Thomas said if doctors could reduce AGEs levels in the body, along with current strategies to control sugar, cholesterol and blood pressure, then it may be possible to avoid the complications of diabetes, including damage to the kidneys, eyes and heart vessels.

"What we’re wanting to do with AGEs is the same thing that’s been done with cholesterol," Prof Thomas said in an interview. "We want to establish what increases AGEs in the body and what is the best way to reduce them." Some medications to treat AGEs already exist.

But others are being developed, including international human trials of a novel drug, known as alagebrium, which aims to break down pre-existing AGEs and make hardened tissue supple again.

"It’ll be a couple of years before we have the full results but our preliminary studies have been extremely positive," Prof Thomas said. "The key to reducing the impact of diabetes is to break the link between high sugar levels and the damage they cause. AGEs are one of those links and this will provide an important advance to their care."
Baker Heart Research Institute news release, Sept, 30, 2005

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DID YOU KNOW:
The Benefits of Exercise Even Without Diet: A recent study published in Diabetes Care (2005) investigated the health benefits of following a resistance-training program for 16 weeks, twice a week in Type 2 Diabetic men without following a weight loss diet. In 16 weeks, the men in the study showed improvements in their body’s response to insulin, the resting sugar levels and their total abdominal health. What is important to note is that the favorable changes in the men’s health occurred without modifying their diet, proving that exercise is an extremely powerful health modulator when completed in regular intervals. Modifying the diets of the participants with a larger quantity of fruits, vegetables, whole grains and lean protein would have probably contributed to weight loss and even further gains in health.