By Laura Mizoue

Wouldn’t it be great if everyone with diabetes could earn a lifetime achievement award for disease management? Given the skyrocketing costs of diabetes care in the U.S., this sounds like a win-win scenario. And maybe proteomics can make it happen.

The Joslin Diabetes Center, an affiliate of Harvard Medical School, gives victory medals (actual bronze medallions) to people who have lived with insulindependent (type 1) diabetes for over 25 years. The program started in 1948, and now there are not only 25, but also 50, 75 and even 80-year award winners!

The amazing thing about Joslin Medalists is how they’ve managed to escape a lot of the serious diabetes-related complications — such as eye, heart, nerve and kidney damage — that can drastically reduce quality of life. So what’s their secret? How can someone with type 1 diabetes not only survive, but thrive?

Even though diabetes is the leading cause of chronic kidney disease worldwide, fewer than 10 percent of 50-year Medalists have kidney problems. A recent study published in Diabetes Care found that Medalists who remained kidney disease-free had higher levels of glucose metabolism proteins — and correspondingly lower levels of toxic glucose metabolites — in their blood. These proteins circulate throughout the body, so it’s possible that they are helping Medalists resist damage to other organs as well. And there was some evidence to suggest that protective proteins are working in people with type 2 diabetes.

Identifying blood-borne proteins that track with good health outcomes would make it easier for other diabetics to emulate Joslin Medalists. Doctors and patients could formulate personalized treatment plans and then gauge their effectiveness from a simple blood test. Does switching to a gluten-free diet increase my levels of protective proteins? Does lack of exercise or sleep cause them to decrease?

The Medalist findings made me wonder whether similar protein defenders are coursing through my mother’s veins. My mom doesn’t have diabetes, but she could win a 60-year award for managing chronic kidney disease. Maybe the same proteins found in Medalists have allowed her to avoid dialysis while continuing to enjoy her favorite junk foods. Or maybe she has a different set of protein bodyguards.

Even though no one’s quite figured out a copycat recipe that will help everyone with diabetes live the longest and healthiest life possible, I bet the key ingredients are proteins.

 

Citation: Gordin, D et al. (2019) “Characterization of glycolytic enzymes and pyruvate kinase M2 in type 1 and 2 diabetic nephropathy.” Diabetes Care, 42(7):1263-1273. https://www.ncbi.nlm.nih.gov/pubmed/31076418