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WHAT IS THE HEMOGLOBIN (HBA1C) TEST?
Getting pricked with needles multiple times during a two-hour glucose tolerance test is cumbersome. This is why the World Health Organization, CDC, and American Diabetes Association have come to rely on the glycated hemoglobin (HbA1c) test to assess the diabetes continuum. When blood glucose is increased outside of the biological range for an extended period of time, it attaches itself to biological proteins, including the heme (iron)-containing portion of our red blood cells, through a process called glycation. As such, HbA1c is widely used to quantify long-term blood-sugar control, while fasting or random glucose is more representative of short-term management.
WHAT IS GLYCATION AND ADVANCED GLYCATION?
The twentieth-century chemist and physician L. C. Maillard, MD, discovered that sugars such as glucose could readily react with proteins to form a glucose-protein complex. Since all proteins in the body are capable of undergoing the glycation associated with hyperglycemia, there is emerging research suggesting that glycated albumin—a protein commonly present in the blood stream—is more sensitive than HbA1c. Increased glycated albumin is also an independent risk factor for coronary artery disease.
Glucotoxicity is an unwelcome side effect associated with increased unregulated blood-sugar levels common to insulin resistance and type 2 diabetes. AGEs, or advanced glycation end-products, is the scientific term describing the compound created when excess sugar attaches to or mixes with proteins of the body, such as hemoglobin.
The immune system recognizes AGEs in a similar lock-and-key fashion that occurs when bacterial endotoxin leak through the intestine. The receptors that sense these sugar-protein complexes, or AGEs, are called RAGEs, for receptors for advanced glycation end-products, which ignite cellular inflammation. Levels of these receptors correlate with poor metabolic health, including increased belly fat and diabetes.
Impaired blood-sugar control and excessive intake of fructose and D-ribose are not the only ways to unnecessarily expose your body to AGEs. We are now finding that cooking methods may be as important for metabolic health as the nutrients contained within the food. For example crisp, deep-fried, broiled, grilled, and roasted foods are rich in AGEs. Consumption of AGE-rich foods has recently been linked to impairments in glucose balance, satiety, and pancreatic function—that is, independent of sugar or calorie excess. Scientists at Mount Sinai School of Medicine suggest that boiling and stewing blood-sugar imbalances, and more.
To learn more about AGEs and cooking, watch the video below.
Davis, K. E., Prasad, C., Vijayagopal, P., Juma, S., & Imrhan, V. (2014). Serum soluble receptor for advanced glycation end products correlates inversely with measures of adiposity in young adults. Nutrition Research. doi:10.1016/j.nutres.2014.04.012