Why do some diabetics not get complications

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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.

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explains Valeriya Lyssenko, who along with 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

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.