RELATIONSHIP BETWEEN GLYCEMIC CONTROL AND COLLAGEN-LINKED ADVANCED GLYCOSYLATION END-PRODUCTS IN TYPE-I DIABETES

OBJECTIVE - To evaluate the relationship between glycemic control over a 3-yr period and tissue levels of advanced glycosylation end product s. The development of renal failure, blindness, and generalized vascul ar occlusion continue to be the most serious ravages of diabetes. Tiss ue glycosylation and AGEs are felt to play an important role in the de velopment of these sequelae, but no data are available on the relation ship between AGEs and long-term glycemic control. RESEARCH DESIGN AND METHODS - we studied 48 subjects with diabetes. Glycemic control was d etermined by mean levels of HbA1, and AGEs were determined on collagen ase digests of skin collagen by fluorescence at excitation/emission re adings of 335/385 and 370/440 nm. RESULTS - To evaluate the relationsh ip between glycemic control and AGE levels, control was classified as good (less-than-or-equal-to 8.5%), fair (> 8.5% but less-than-or-equal -to 1 0%), or poor (> 10%) on the basis of mean HbA1 levels during 1- and 3-yr periods. Analysis of the mean AGE levels for each level of gl ycemic control over 1-3 yr showed that AGEs differed significantly acr oss categories of glycemic control (P = 0.04 and 0.003), with the lowe st AGE levels associated with good and the highest with poor glycemic control. The relationship also was highly significant when adjusted fo r age, sex, and duration of diabetes, and when examined by Pearson's c orrelation coefficients (P = 0.02 and 0.008). CONCLUSION- Finding a re lationship between glycemic control over 1-3 yr and tissue levels of A GEs suggests that AGEs can be modified and possibly reversed by improv ed glucose levels.