Have you ever wondered why people with Diabetes are at higher risk to get certain types of health problems? If you have Diabetics in your family, you know what I’m talking about: blindness, increased risks of heart attacks, kidney failure, nerve damage, sexual dysfunction, infections, amputations, etc. That’s quite a pile of issues (and that’s a partial list). But why those problems?
When I was in medical school, I learned this maxim: “The rule of the artery is supreme!” Sounds pompous, doesn’t it? What it means is this; our body parts can’t live with out being supplied continuously with nutrition, oxygen, electrolytes, all kinds of things. And anything that disrupts that artery from bringing the goods leads to downstream damage to anything on that arteries delivery route.
One year, early in my career, I got so busy at the hospital I neglected to water my lawn for a few weeks in summer. By the time I realized I had forgotten something, it was too late. The lawn had burned up and I was “that’ neighbor! A sage neighbor explained it to me. “Hey buddy, if you don’t water the grass, the grass dies!”
Our bodies are like that lawn, and those arteries are the garden hose. If you don’t “water” your organs, or toes…they die.
So now we know “why” we see the types of problems people with diabetes may experience. But what I really want to talk about is “how” Diabetes causes all that vascular damage. And as a spoiler alert, if you aren’t a person who has diabetes, you should probably read this whole article as it has some hints for your health as well.
Candy apples
Have you ever heard of an A1C test? It’s a test your doctor checks a few times a year to see how well blood sugars are being controlled. The test measures the amount of sugar stuck to our red blood cells and extrapolates what an average blood sugar has been for a few months. I tell patients an A1C is like a caramel apple. The more times you dip the apple in the caramel bucket the thicker the coat on the apple will be. It’s the same for our blood cells as well. The effect of sugar sticking to other types of tissues and cells in our body is called glycation. This is the culprit causing much of the trouble in Diabetes!
Don’t Sugar coat it Doc, what’s the problem?
I tell my patients that when blood sugars remain consistently high, the blood becomes like napalm, wreaking havoc on blood vessels. Excess sugar binds to proteins in our bloodstream, arteries, and organ tissues, resulting in the formation of "Advanced Glycation End-products," which we'll call AGEs. These AGEs are permanent complexes of sugar and proteins that accumulate in our bodies and contribute to the development of various diseases.
Do AGE’s... age us?
Indeed, they do. Excessive exposure to AGEs appears to accelerate the aging process, trigger inflammation, damage blood vessels, and accumulate in critical organs like the brain, heart, and kidneys, leading to disease. The cumulative effect of all this damage is significant.
For instance, AGEs alter the physical properties of our tissues, typically for the worse. Ever heard of "hardening of the arteries"? This arterial stiffness can lead to conditions like high blood pressure. Similarly, just as starch stiffens a shirt, AGEs stiffen our arteries, potentially resulting in heart attacks and strokes. Furthermore, AGEs can also stiffen cartilage, contributing to early osteoarthritis and long-term joint problems.
Now, if Alzheimer's dementia runs in your family, you're likely familiar with the amyloid plaques that accumulate in the brains of affected individuals. AGEs, with their permanent damage to proteins and their formation processes, can play a role in the development of these brain plaques.
AGE cause inflammation. Our bodies know AGE’s can harm us so the immune system goes on high alert trying to clean up the mess. Chronic inflammation and oxidative stress takes a serious toll on our health!
So, by now, I’m hoping we are all thinking we don’t want those AGEs to be building up in our bodies! If you are a person with Diabetes maybe you are thinking, I need to make sure my blood sugars are well controlled. That certainly is an important takeaway from all of this. But it isn’t the most important one.
You see, AGE’s get into our body in two ways: endogenously (they were built in our body) or exogenously (they were produced outside our body and then we consumed them). So far, we have been talking about AGE’s created by having high blood sugars. But research shows that we are exposed to more AGEs from what we eat and how we prepare our food than what we produce inside our bodies.
This is where we invite the non-diabetics to the conversation. Remember, heart attacks, strokes, vascular disease, cancers, and dementia happen to folks who aren’t diabetic all the time. Excess exposure to AGE’s drives disease risk for all of us.
Don’t eat Diabetic cows!
Foods that are high in AGE’s are predominantly animal products- such as meat and dairy. This may be influenced by how we raise them. Animals that are fed on grain and corn crops produce more AGEs in their tissues than grass-fed, free-range animals. They tend to be more insulin resistant and have more visceral fat built up in their muscles. This is the same process that leads to Diabetes in people. It could be the case we are inadvertently being exposed to food products that aren’t as healthy for us as they once were. In a weird way, It’s as if eating a diabetic cow leads to us absorbing diabetic problems!
AGEs are also impacted by how our foods are prepared. Meats that are prepared in high dry temperatures: IE roasting, broiling, grilling and frying all cause more AGE’s to be created than cooking with lower wetter temperatures: boiling, stewing, crockpot, steaming, even microwaving (though, I have a bias against cooking anything in a microwave!).
So, whether we have Diabetes or not, how much we are exposed to AGEs in our diet can have a tremendous impact on our risk of “Diabetic like “complications.
What is the takeaway? Eat a balanced diet that is plant heavy and lighter on animal products. Try to pick animal products that are produced from animals fed naturally. Finally, prepare your foods with lower wetter temperatures. Eating less AGE’s will help you “age” more slowly!