Glycation Reactions and the Development of Diabetes

Dr. Rex Mahnensmith serves the internal medicine needs of Hartford, Connecticut, patients and currently focuses on meeting the needs of families and individuals in skilled nursing facilities. Well published in his field, Dr. Rex Mahnensmith has written on glucose glycation reactions and how cell and tissue injury arise in both diabetes and prediabetes patients.
With both Type 1 and Type 2 diabetes, a prolonged period of elevated glucose concentrations results in glycation events. These are random reactions through which glucose molecules attach without enzyme facilitation and without protein or lipoprotein molecule mediation. Ungoverned and unhealthy, glycation involves undesirable protein or lipoprotein changes that can accumulate in an irreversible manner.
Lack of insulin and resistance to insulin, as well as elevated glucose concentrations, are directly tied to prediabetes. No longer considered a “herald’s disease,” prediabetes involves glucose circulating at higher-than-normal levels after meals. It also involves circulating red blood cells with abnormal concentrations of glycated hemoglobin and an increased number of glycation events. With tissues damaged more and more as prediabetes progresses, medical intervention is typically required.
