[acb-diabetics] Why do some diabetics not get complications

[Patricia LaFrance-Wolf]

Why Do Some Diabetics Escape Complications?


ScienceDaily (Jan. 23, 2011) — Much research has been carried out on why
diabetics develop complications. Now researchers are asking the question the
other way around. They want to know why some diabetic patients do not
develop complications. What is it that protects them? The PROLONG study
could provide the answer.

  _____  

explains Valeriya Lyssenko, who along with Peter Nilsson, both from Lund
University Diabetes Centre, leads the PROLONG (PROLONG stands for PROtective
genes in diabetes and LONGevity) study.

Stiff sugary arteries

Major diabetic complications include kidney disease (nephropathy), eye
damage (retinopathy), heart attacks and stroke. Despite decades of intensive
research on diabetes complications, the fundamental mechanisms are not yet
fully known. Neither is it possible to prevent or treat the damage to the
blood vessels that affects the majority of diabetics.

The risk of dying from cardiovascular disease is two to three times higher
for diabetics than for non-diabetics. The small blood vessels are also
damaged. After only ten years with diabetes, 70 per cent of patients will
have some form of kidney damage that may progress to kidney failure. As many
suffer from eye complications -- some will develop severe visual impairment
and two per cent will become blind.

"The blood vessels and other organs of the body become sugar coated and
stiff. It is reminiscent of premature biological ageing," says Peter
Nilsson.

Half of the veterans

Perhaps nature itself can answer the question of why some patients are
protected. This is what the PROLONG study will investigate.

Today there are approximately 12 000 people in Sweden who have had diabetes
for more than 30 years; of these, 1 600 have had it for over 50 years.

"About half of these diabetic veterans do not have major complications. Two
thirds of those who have had diabetes for more than 50 years have escaped
complications. Clearly they are different and we want to find out what it is
that protects them," says Valeriya Lyssenko.

Greatest risk passed after 30 years

The PROLONG study is starting now in Skåne with a pilot study of patients
with diabetes duration of more than 30 years. At a later stage patients will
be recruited from all hospitals and health care centres in Sweden. They will
be compared with diabetics who have already developed severe complications
despite having had diabetes for less than 15 years.

The 30-year limit has been chosen because a person who has had diabetes for
such a long time without developing complications is unlikely to do so later
in life.

Copying nature's protective mechanisms

Participants in the PROLONG study will answer questions about their
lifestyle and about diseases they, or their closest relatives, may have.
Various blood samples, including genetic tests, will be analysed, and close
relatives of the participants will also be invited to take part in the
study.

"If we can identify factors protecting these veterans from devastating
complications, then it might be possible to develop drugs that can do the
same thing," says Valeriya Lyssenko.

 

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