Glycation. Glycation is a random reaction between the ordinary glucose molecule and any tissue or any macromolecule in our bodies. Glycation is not enzyme-directed. It is not enzyme-facilitated. Glycation serves no positive purpose. Glycation is a chemical reaction between a substance – glucose – which has the property of sharing an electron with another molecule – and a receiving molecule, most usually a protein or lipoprotein. A glycation event is an irreversible union of glucose with a receptive molecule. Receptive molecules include hemoglobin, capillary endothelial cell membrane proteins, and structural membrane proteins of numerous organs, such as kidneys and nerves. Glycation reactions in our bodies occur when glucose molecules circulate too long in the blood stream – having not been transported into cells and tissues by insulin. How long is too long? Too long most certainly is greater than 3 hours. Even two hours can be too long. This random attachment of glucose changes the basic nature of the proteins and membranes. Glycation is undesirable, for it initiates and perpetuates disease on the organs affected.
Type 1 Diabetes Mellitus. Type 1 Diabetes Mellitus features relative insulin lack or insulin deficiency as its basic root cause. Insulin is present but in sub-normal concentrations. Insulin secretion in response to a glucose-containing meal is low, sluggish, and sub-normal, as well. The basic problem resides at the pancreas beta-cell, which are the cells where insulin is manufactured and secreted in response to glucose surges in our blood stream. Physicians can and do prescribe various insulin forms and dosages to repair and remedy the insulin deficiencies. But, a basic second problem can persist – glucose is not transported into target organ cells as promptly as would occur in the perfectly healthy state. Hence, blood glucose concentrations can be lowered with prescribed insulin preparations, but glucose absorbed from our meals still circulates too long and at higher than normal concentrations. Then, glycation events result. Tissue membranes are affected. Capillary wall membranes are affected. Organ disease results and progresses.
Type 2 Diabetes Mellitus. Type 2 Diabetes Mellitus features resistance to insulin action at the target tissue level. Insulin production and insulin secretion by the pancreas beta-cells is not below normal. In fact, insulin secretion is either normal or above normal. Most commonly, insulin secretion and presence rises in a biologic attempt to overcome the insulin resistance and to transport circulating glucose into the target tissues. Physicians will prescribe various pill forms of diabetes medications that aim to improve blood glucose and will even add various forms of insulin on top of the already present natural insulin. These interventions can help. Still, though, the blood stream glucose concentrations will linger in higher-than-normal ranges, perpetrating and perpetuating glycation events at various sites.
Prediabetes. Prediabetes is a recognizable condition where an individual experiences elevated blood glucose concentrations after a long fasting period, or will exhibit higher-than-physiologically normal glycated hemoglobin levels. Yes, elevated glycated hemoglobin events labels a person as being prediabetic. The elevated glycated hemoglobin concentration is not severe, but it is real. Hence, the person is diagnosed with prediabetes. Why call this prediabetes if glycation events are super-normal? What not call this condition Type 3 Diabetes? Well, prediabetes is a condition that does not mandate a diabetic pill or an insulin prescription. Prediabetes can be reversed and normalized with diet pattern alterations, with sustained weight loss, and with regular exercise. Nevertheless, prediabetes features glycation events, which are known to be harmful if left to progress and accumulate.
Actions. All three of these metabolic disorders are real. All three feature abnormalities of glucose metabolism. All three feature glycation events. The glycation events are the harmful and hurtful consequences of altered glucose metabolism. Action is essential. Action begins with awareness and with understanding. Action hinges on consuming small and smaller quantities of simple carbohydrates at any and every meal, of avoiding sugary snacks and drinks, and obtaining expert diagnosis, counsel and management of your particular condition. Know this and do this.
Rex Mahnensmith is a practicing Internal Medicine Physician who has special concern for persons with diabetes, prediabetes, glucose intolerance, and body weight concerns. He believes that prevention is key and awareness is essential.