Diabetes and Glycation

In 2020, diabetes has been diagnosed in 34.2 million individuals^{2}. It is undiagnosed in 7.3 million people^{2}. Prediabetes is also prevalent in 88 million individuals that are 18years of older^{2}. These rates are growing year by year. Diabetes has become the world’s most significant cause of morbidity and mortality. We have seen how deadly it can be with COVID infection.  There are several causes and risk factors for diabetes such genetics, metabolic dysfunction, nutrition, and socioeconomic and ethnic backgrounds.

With metabolic dysfunction, glucose is not transported effectively within the body to where it needs to be. This dysregulation leads to hyperglycemia which can eventually cause damage to the arteries, kidneys, skin, and other parts of the body.

The rise in glucose within the body can induce glycation. Glycation is an abnormal process where reduced sugars, such as glucose, binds to fat and protein making an inflammatory molecule called Advanced Glycation End Products(AGES). The attachment causes dysfunction in both fat and protein. Glycation alters enzymatic activity and thereby prevents metabolic functions from working properly.

It can damage structural and functional proteins which are required for normal body function and building blocks for connective tissues^{3}. This causes a disruption in collagen synthesis and bone remodeling leading to skeletal fragility ^{3}.

Normally, AGES increase with normal aging, but it has been fueled due to food preparation techniques. Studies have found cooking foods at high temperatures, such as frying, grilling, broiling and roasting, increases and speed up glycation ^{4}. Cooking at lower temperatures and in the presence of water decrease AGES formation ^{1,4}. Higher fat and protein containing foods, as well as processed foods, contain higher content of AGES compared to high vegetable carbohydrate and unprocessed foods^{4}.

It is recommended, in order to help decrease AGES and delay the onset of diabetes, one should adopt a low AGES diet – cooking at lower temperatures (boiling, steaming, baking, stewing, poaching), eating whole foods (vegetables, fruits, whole grains), and limiting sugar intake. This is not only to help delay the onset of diabetes but also help to decrease the side effects of diabetes (glaucoma, cataracts, nephropathy, etc) ^{1}.

1. “Cooking and Storing.” Nutritional Medicine, by Alan Gaby, Fritz Perlberg Publishing, 2017, p. 15.
2. “National Diabetes Statistics Report, 2020.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 28 Aug. 2020, www.cdc.gov/diabetes/data/statistics-report/index.html.
3. Singh, Varun Parkash, et al. “Advanced Glycation End Products and Diabetic Complications.” The Korean Journal of Physiology & Pharmacology, vol. 18, no. 1, Feb. 2014, pp. 1–14., doi:10.4196/kjpp.2014.18.1.1.
4. Vlassara, Helen, and Jaime Uribarri. “Advanced Glycation End Products (AGE) and Diabetes: Cause, Effect, or Both?” Current Diabetes Reports, vol. 14, no. 1, 2013, doi:10.1007/s11892-013-0453-1.