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The Link Between Blood Sugar and Aging: Understanding Glycation


As we age, our bodies undergo various changes, including the way we process and regulate blood sugar. Blood sugar, or blood glucose level, plays a crucial role in human physiology as it serves as the primary fuel for our central nervous system. However, maintaining a healthy blood glucose level is not only important for immediate well-being but also for the long-term aging process.

In this article, we will delve into the concept of glycation and its impact on aging. Glycation is a non-enzymatic process that occurs when proteins react with sugars, leading to the formation of advanced glycation end products (AGEs). These AGEs can cause damage to cells and tissues by reacting randomly with vital molecules such as proteins and DNA.

The Mechanism of Skin Glycation

Glycation, also known as non-enzymatic glycosylation, is a major cause of aging and degenerative diseases. It begins when glucose molecules attach themselves to proteins, initiating a chain of chemical reactions that result in protein crosslinking. This crosslinking alters the biological and structural roles of proteins, leading to tissue deterioration commonly associated with aging.

Advanced Glycosylation End products (AGEs) are the crosslinks of proteins like collagen and elastin, which can toughen tissues and contribute to age-related deterioration. AGEs have been linked to various age-related deficiencies, including stiffening connective tissue, hardened arteries, clouded eyes, loss of nerve function, and less efficient kidneys.

AGEs exert their harmful effects by physically impairing proteins, DNA, and lipids, altering their chemical properties. Additionally, they act as cellular signals, triggering destructive events when they bind to their specific cellular binding sites, such as the receptor for AGEs (RAGE). This binding initiates cellular activation and oxidative stress, leading to a self-amplifying “positive feedback loop” that results in widespread cellular activation and tissue damage.

Fortunately, our bodies have a defense system against crosslinking. Macrophages, immune system cells equipped with special receptors for AGEs, seek out these compounds, engulf them, break them down, and eliminate them through the bloodstream and urine. However, this defense system is not entirely foolproof, and AGE levels increase steadily with age due to declining kidney function.

The Role of Carnosine in Combating Glycation

Carnosine, a dipeptide composed of beta-alanine and 1-histidine, has shown remarkable potential in combating glycation and its detrimental effects on the aging process. Studies have revealed that carnosine can inhibit the formation of AGEs and protect normal proteins from the toxic effects of already formed AGEs. It has also been found to react with and remove carbonyl groups in glycated proteins, offering a three-stage protection against the accumulation of aberrant proteins.

Unfortunately, carnosine levels decline with age, making supplementation crucial, especially for individuals who have reduced their meat intake, the primary dietary source of carnosine. As research progresses, carnosine may become an integral component of future anti-glycation therapies, offering promising results in the fight against aging.

The Impact of Glycation on Aging

Protein glycation, the non-enzymatic modification of biomolecules by reactive carbonyl compounds, has garnered significant interest due to its potential role in the aging process. While numerous theories attempt to explain the causes of aging, many postulate that the accumulation of damage to proteins, nucleic acids, and other biomolecules contributes to this inevitable process.

Glycation, alongside other mechanisms such as free radical damage, is believed to cause irreversible damage to proteins in tissues with slow turnover rates. This damage can result in the loss of tissue strength and elasticity observed in aging individuals. Additionally, elevated levels of glycation and AGE compounds have been linked to diabetic complications, atherosclerosis, and neurodegenerative diseases.

Understanding the balance between the rate of glycation and elimination is crucial in comprehending the implications of AGE accumulation. Proteins with short half-lives and high clearance rates are less prone to glycation and AGE formation due to their rapid degradation or excretion. In contrast, long-lived proteins, such as those found in the eye lens, skin, and cartilage tissue, are more susceptible to AGE accumulation, leading to visible tissue yellowing and high autofluorescence.

The Role of Glycation in Diabetic Patients

Diabetic patients often exhibit elevated levels of glycated serum proteins, highlighting the connection between blood sugar control and glycation. Glucose, the most abundant reactive carbonyl compound, is responsible for the majority of glycation reactions. While glucose has lower reactivity, other carbohydrates and oxo-carbonyl compounds, like methylglyoxal (MG) and glyoxal, are highly reactive and can lead to rapid AGE formation.

The glycation process is slow, taking days, weeks, or even months to complete. Consequently, tissues with slow protein turnover rates, such as collagen in the skin and cartilage, tendons, and crystallin in the eye lens, experience the highest levels of AGE accumulation. This accumulation alters the biophysical properties of structural proteins, contributing to the loss of tissue strength and elasticity commonly associated with aging.

Exogenous Sources of AGEs

Aside from endogenous glycation processes, exogenous sources contribute to the detectable AGE load in our bodies. Processed foods and smoking are major exogenous sources of AGEs. The Maillard reaction, also known as the browning reaction, occurs during thermal heating or cooking, resulting in the formation of AGE compounds. Food-derived AGEs, which have progressed to a higher level of AGE formation than endogenously formed compounds, can impact physiological processes differently.

It is important to note that the pathophysiological significance of food-derived glycotoxins, as AGEs are sometimes referred to, is controversial and beyond the scope of this article. However, it is clear that the accumulation of glycated and AGE-modified proteins can have negative health consequences.

The Biological Effects of Glycation

Glycation can alter the biophysical and biological properties of proteins through covalent modifications. Structural changes in glycated proteins, such as albumin, have been extensively studied. These modifications can impact drug-binding capacity, with some drugs exhibiting increased affinity for glycated proteins while others experience decreased affinity.

The primary mechanism through which glycated proteins and AGE compounds exert their physiological effects is through binding to specific signaling receptors. The receptor for advanced glycation end products (RAGE) is the main signaling receptor for AGEs. Activation of RAGE by AGEs triggers proinflammatory signaling, NF-κB activation, and cytokine release in various cell types and tissues. Chronic RAGE activation has been associated with the progression of diabetic complications, neurodegenerative diseases, and vascular dysfunction.

Understanding the molecular mechanisms of the AGE-RAGE axis and developing pharmacological approaches to modulate RAGE activation have become areas of great interest in the field. By targeting this pathway, researchers hope to mitigate the detrimental effects of glycation and AGE accumulation.

Analyzing Glycation: Methods and Biomarkers

Analyzing the glycation process and measuring AGE compounds in biological samples is a complex task due to the multitude of glycation reactions and the simultaneous formation of different AGE products. Currently, no standardized method exists to comprehensively measure glycation, necessitating an understanding of the various methods described in the literature.

One notable success in utilizing glycated proteins as clinical markers is the measurement of glycated hemoglobin (HbA1c) levels. HbA1c has become a widely used marker for long-term blood glucose control. Its levels provide valuable information about glycemic control over the preceding months.

Efforts are underway to establish the glycated form of albumin (GA) as a clinical marker for glycemic control. Compared to hemoglobin, albumin has a shorter half-life and is more responsive to changes in glycemic control. GA may prove beneficial for patients with abnormal HbA1c levels due to anemia or variant hemoglobin.


The link between blood sugar and aging is complex and multifaceted. Glycation, the non-enzymatic modification of proteins by reactive carbonyl compounds, plays a significant role in the aging process. The formation of AGE compounds can lead to cellular damage, tissue deterioration, and the progression of age-related deficiencies.

Fortunately, there are potential solutions to combat glycation and its effects. Carnosine, a dipeptide with anti-glycation properties, shows promise in protecting proteins from glycation damage and reducing the accumulation of AGEs. Additionally, understanding the role of glycated proteins and AGE compounds in disease progression can pave the way for targeted treatments and interventions.

As research continues, it is crucial to explore comprehensive methods to measure glycation and identify suitable biomarkers that reflect the glycation process accurately. By gaining a deeper understanding of glycation and its impact on aging, we can work towards developing strategies to promote healthy aging and mitigate the negative consequences of glycation-related processes.

Remember, maintaining optimal blood sugar levels is vital not only for immediate well-being but also for long-term health and graceful aging.


[1] Reference Article 1
[2] Reference Article 2