Advanced glycation end product accumulation, insulin resistance share two-way relationship
Insulin resistance and the accumulation of advanced glycation end products in the skin have a two-way relation for adults with type 1 diabetes, according to findings in the Diabetic Magazine.
Skin autofluorescence has been shown to be higher in people with diabetes than in healthy controls and correlates with the results of [advanced glycation end product] accumulation in the skin biopsies and with Hemoglobin (HbA1C) levels. Moreover, skin autofluorescence is related to the development and progression of chronic diabetic complications.
They recruited 476 adults with type 1 diabetes (median age, 42 years) from the department of internal medicine and diabetology at the Poznan University of Medical Sciences in Poland to assess the association between skin and autofluorescence and estimated glucose disposal rate (eGDR), which was used as an analogue for insulin resistance and sensitivity.
The researchers collected fasting blood sugar samples from each participant, using the sample to measure plasma glucose, total cholesterol, HDL cholesterol, triglyceride levels, LDL cholesterol, HbA1C, and estimated glomerular filtration rate. In addition, an advanced glycation end product (AGE) reader was used to measure skin autofluorescence three times, with measures taken on the ventral site of the forearm. The means of three measurements was used in this analysis.
Insulin resistance and sensitivity were determined via an equation created by the researchers for eGDR, with lower eGDR denotating higher insulin resistance. After these measurements, three subgroups were formed. The first were participants with eGDR of less than 5.5 mg/kg per minute, the second was for a participant with eGDR 5.5 mg/kg per minute to 9 mg/kg per minute, and the third was for participants with eGDR of more than 9 mg/kg per minute.
Roughly all the participants had low insulin sensitivity, which was defined as eGDR of less than 7.4 mg/kg per minute. As eGDR increased, skin autofluorescence decreased (P < .0001). According to the researchers, this information provides evidence of a negative correlation between AGE and eGDR (P < .0001). They added that this association was two-way based on multiple logistic regression models.
This relationship is certainly bidirectional, with both pathogenic processes mutually influencing each other. This vicious circle increases the risk of diabetic angiopathy and worsens the prognosis for people with type 1 diabetes. To improve the prognosis in type 1 diabetes, it is extremely important to maintain good metabolic control from the beginning of the disease in order to prevent the development of insulin resistance; however, further research is needed to determine if the insulin resistance can be influenced by decreasing AGE formation and if lowering AGE accumulation can improve insulin sensitivity.
I have type 2 diabetes. I have to take medication and insulin. The doctor decreased the amount of insulin and gave me Victoza instead. That’s been good for me so far.