How to stop diabetes wreaking lasting havoc
How to stop diabetes wreaking lasting havoc
* 29 June 2007
* NewScientist.com news service
* Andy Coghlan
One of the nasty tricks that diabetes has up its sleeve is the ability to carry on harming people long after they have got the level of glucose in their blood under control. Now researchers think they may be able to stop this, using cheap available drugs.
The idea builds on the discovery that when cells are exposed to the high levels of glucose typical of diabetes, proteins within the cells’ mitochondria suffer damaging changes. The proteins become permanently attached to sugar-like molecules called glycans, and this not only prevents them doing their job properly but also makes them produce harmful molecules called reactive oxygen species.
The reactive oxygen species circulate throughout the body, attacking and damaging tissues, particularly in the limbs and eyes. Because the changes to the cellular proteins are not reversible, they continue to pump out these molecules even when glucose levels have returned to normal. "This contributes to the development of diabetic complications," says Antonio Ceriello of the University of Warwick in Coventry, UK, whose team now think there may be a way to stop this happening.
The clue came from lab experiments in which they took damaged cells that had been previously exposed to high levels of glucose, and showed that the reactive molecules could be neutralised by exposing the cells to antioxidants such as alpha-lipoic acid (Diabetologia, DOI: 10.1007/s00125-007-0684-2).
In a trial on 36 patients undergoing insulin treatment for type 1 diabetes, they were then able to show that injections of vitamin C could have the same effect in people, as did a blood-pressure-lowering drug called telmisartan. "These compounds can counteract the ‘memory’ because they work inside cells to block free-radical production," says Ceriello, who will publish the results of the trial in the journal Diabetes Care.
“In a trial of 36 patients, injections of vitamin C neutralised the reactive molecules that were responsible for the damage”
The researchers point out, however, that people would have to take such antioxidants for life, to mop up the continuous supply of reactive molecules being produced by the damaged proteins. So they are now looking for other potential drugs that might permanently reverse the chemical changes that stopped the protein’s normal function.
Ian Frame, research manager at the charity Diabetes UK, cautions that the timescale of the experiments was relatively short, so the proposed treatments might not work in people with chronic diabetes. However, he does say the results are a "step forward" in establishing how reactive oxygen species contribute to long-term complications of diabetes.
From issue 2610 of New Scientist magazine, 29 June 2007, page 11
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