Metabolic Risk Factor for Complications in Type 1 Diabetes

Although most patients with type 1 diabetes eventually develop microvascular and macrovascular complications, some do not. Investigators at Boston's Joslin Diabetes Center studied 351 patients who were followed carefully for at least 50 years after diagnoses of type 1 diabetes. Remarkably, despite decades of disease, many of these patients remained free of nephropathy (87%), cardiovascular disease (52%), proliferative retinopathy (49%), and neuropathy (39%).

Complications in this cohort were not associated with current or longitudinal levels of glycosylated hemoglobin (HbA_1c). Microvascular disease was not associated with blood pressure and lipid levels. In contrast, high levels of specific advanced glycation end products (AGEs) raised the r…