Diabetic ketoacidosis is awful. One star awful, would not recommend. When I looked at myself in the hospital mirror, I almost screamed. Overnight, I’d aged ten years, and I looked witchlike. Part of it was down to the severe dehydration from the ketoacidosis and resolved within the next few weeks. But there was something more that made me look older that remained. It was the result of months and months of high blood sugar before my diabetes diagnosis. There was no going back.
Just like smokers, diabetics often age faster than their fellow human beings. High blood sugar works on a cellular level in several ways. The first problem is the glycation of proteins and lipids. Glycation happens when sugar levels in the blood rise to the point where the sugars start attaching themselves to the fats and proteins. When we measure HbA1c levels, we determine blood sugar levels for the past three months. We do this by looking at how much sugar has attached itself to the hemoglobin protein of our red blood cells. Glycated hemoglobin is an advanced glycation end product (AGE), and unless your future beauty ideal is a raisin, you want low levels of these. The collagen protein in our skin decreases with age. For this reason, wrinkles form, and more glycated collagen is one of the main reasons diabetics look older.
High blood sugar also leads to the production of pro-inflammatory cytokines and reactive oxygen species. Not only do these things make you look old, but they also cause retinopathy, nephropathy, neuropathy, and heart disease. The recommendation from most dermatologists to prevent aging is to use sun protection, eat a well-balanced diet, and avoid smoking. For diabetics, you also need to keep your blood sugar in check. In other words, throw out your anti-wrinkle cream and invest in a copy of the Diabetes Solution.
I’ve come to view diabetes as I view smoking. The occasional cigarette is not going to kill you, but if you smoke every day you might see trouble. Normal blood sugar should be your treatment target, even if you don’t always achieve it. No one wants to go through life worrying about reactive oxygen species and AGEs destroying your insides and outsides. It’s the best reason I can think of to keep a close eye on your blood sugar levels, even if it means making some sacrifices on the food front.