At some point in every person’s life, thoughts about aging arise. For some, aging is associated with the onset of diseases typical of old age; for others, with a decline in mental and physical performance; for still others, with the loss of a social role in the family and society. What does the aging process represent? Which factors accelerate and slow it down? How can one influence the aging of the body in the presence of diabetes mellitus? We will try to answer these questions today.
The science of aging — gerontology — views aging as a time‑extended process and an integral part of the program of individual human development. In developed countries, the number of elderly (60–74 years) and old (75–90 years) people, as well as long‑livers (over 90 years), is growing year by year. According to leading gerontologists, as reflected in the UN Program on Aging Research in the 21st Century, studying the aging process is not only of theoretical interest but will also help treat diseases of elderly and old people more effectively, increase their life expectancy, and improve its quality.
It has been established that the rate of the aging process of the body as a whole is not the same at different periods of a person’s life; moreover, different organs and systems age at different speeds. Most experts agree that the body of a healthy person reaches optimal parameters of development and function by the age of 25, and from the age of 35 the aging process gains momentum, manifesting as a decline in the body’s capabilities.
Is there a single cause of aging? The answer to this question is negative. Gerontologists have put forward several hundred theories of aging. Many scientists view aging as the result of “accumulation of errors” — irreversible damage to cells over the course of life. One of the most developed such theories is the free‑radical theory.
Free radicals are active chemical particles capable of destroying the normal molecules of our cells. Free radicals are formed in small quantities as an inevitable “by‑product” of metabolism. The level of free radicals increases significantly when the body is exposed to radiation, ultraviolet radiation, toxic substances, as well as in many diseases, including diabetes mellitus.
But our cells are not defenseless against the harmful effects of free radicals: they are neutralized by the antioxidant system. With age, however, the activity of antioxidant enzymes and the content of natural antioxidants in the body decrease. At the same time, the use of antioxidants increases the life expectancy of laboratory animals. A clear example of combating age‑related changes in humans with the help of antioxidants is modern cosmetic products enriched with antioxidant components that protect the skin from free radicals under the influence of the ultraviolet part of sunlight.
The theory of aging due to glycation is also confirmed. Glycation is the irreversible binding of proteins in our cells with glucose. It occurs at a low rate in the bodies of healthy individuals, but in hyperglycemia in patients with diabetes mellitus, it is greatly intensified.
It is sufficient to recall the well‑known glycated hemoglobin, which reflects the average blood glucose level over a period of about 3 months. In a healthy person, its level does not exceed 5%, while in diabetes mellitus it can reach 10–15%. It has been established that even in people without diabetes, the level of such modified “sugar‑coated” proteins increases with age. In diabetes mellitus, glycation disrupts the normal functioning of proteins and often leads to complications — damage to blood vessels and nerves, and clouding of the lens.
With age, hormonal changes also occur in the human body. A typical companion of aging is a decrease in the amount of sex hormones — estrogens and androgens — as well as a deterioration in the biological action of insulin, which regulates, without exaggeration, all aspects of metabolism.
Against this background, the use of carbohydrates by cells decreases, the proportion of fat in the human body increases, especially in the abdominal area. Starting as early as 20–30 years of age, blood cholesterol levels rise, which increases the risk of developing atherosclerosis. The combination of these metabolic disturbances is usually accompanied by an increase in blood pressure and has received the name “metabolic syndrome.”
In metabolic syndrome, the pancreas begins to produce more insulin to prevent an increase in blood glucose levels. When this mechanism is disrupted, type 2 diabetes mellitus develops — a disease that affects people predominantly in the second half of life.
From this, it is clear that aging and diabetes mellitus are closely related: on the one hand, as a person’s age increases, the incidence of diabetes rises; on the other hand, metabolic disturbances in diabetes accelerate the aging of the body.
However, it is obvious that people of the same birth year can differ very significantly in the degree of age‑related changes. In other words, a person’s chronological age does not always reflect the rate of aging. In this regard, the concept of “biological age” was introduced in gerontology.
Measuring biological age allows one to identify an individual “portrait” of age‑related changes in the human body and outline measures to combat them. Scientists began working on this problem more than 70 years ago and have already proposed several dozen methods for determining biological age. Based on the comparison of biological and chronological age, one can judge the pace of aging of the human body.
If biological age is significantly greater than chronological age, we speak of accelerated aging.
· If it is lower, we speak of slowed aging.
· When the two correspond, aging is called physiological.
It should be noted that the value of biological age characterizes the state of the body at the present time and in no way determines the length of future life.
At our endocrinology clinic and the Laboratory of Pathophysiology of Aging at the Hospital for War Veterans, during the period 2001–2005, about 300 patients with diabetes mellitus were examined. All of them underwent laboratory blood tests, and their biological age was determined using a methodology proposed by the Kyiv Research Institute of Gerontology — the leading scientific institution on the problem of aging in the territory of the former USSR.
We found that the biological age of patients with diabetes mellitus often differed from their chronological age: about 50% of patients had an accelerated rate of aging, and the maximum deviation of biological age from chronological age reached 30 years. Such significantly elevated indicators had previously been observed in veterans of armed conflicts who were treated at the hospital.
We studied in detail the indicators of metabolism that are impaired in diabetes mellitus and established that poor compensation of the disease plays a leading role in accelerating the aging of the body.
In diabetic patients with an accelerated rate of aging, in most cases a high level of blood sugar (hyperglycemia) and glycated proteins was determined; signs of increased formation of free radicals were significantly more common, and blood lipid levels were somewhat above normal.
These disturbances were most pronounced in relatively young people — aged 35–50 years — and they also showed the greatest deviation of biological age from chronological age. It should be noted that diabetic patients with an accelerated rate of aging had a significant excess body weight, while in those with a slowed rate of aging, weight only slightly exceeded the norm.
The contribution of diabetes “duration” and complications to the increase in biological age turned out to be less than expected. These data show how important it is for a patient with diabetes mellitus, in cooperation with the treating physician, to fight the disease and achieve normalization of metabolism — that is, compensation of the disease.
Modern gerontology can influence the speed of the aging process through targeted measures: both by taking medications and by non‑pharmacological methods.
Medications that slow down the aging process and extend the life of laboratory animals are diverse: antioxidants (for example, vitamins A, C, E), stimulants of energy metabolism and immunity, vitamins, some hormones, and detoxification drugs.
Special mention deserves the presence of these properties in antidiabetic drugs from the biguanide group (in endocrinology, one of them is now widely used — metformin). All the listed groups of drugs are used in medicine according to indications for use. However, none of these drugs has yet proven the ability to slow down the aging of the human body, and there are currently no grounds to recommend their use specifically for this purpose.
Non‑pharmacological interventions can have no less significant impact on the rate of aging. The most effective of them — caloric restriction — can increase the life expectancy of experimental animals by up to 1.5 times.
At present, a long‑term study of this method is ongoing in the United States in a group of healthy volunteers, and it has already been established that their metabolic parameters are approaching the “ideal” values of young people.
In our Hospital for War Veterans, the ability of hyperbaric oxygenation and “dry” carbon dioxide baths to reduce the biological age of the body has been identified; indications and contraindications for these methods and optimal treatment regimens have been determined.
Our examination of patients with diabetes mellitus demonstrated similar activity in preparations of lipoic (thioctic) acid, widely used in endocrinology for the treatment of diabetic neuropathy.
We would like to conclude the discussion on the relationship between diabetes mellitus and aging with brief recommendations from leading gerontologists. Thus, in order to slow down the development of age‑related changes, one should:
The science of aging — gerontology — views aging as a time‑extended process and an integral part of the program of individual human development. In developed countries, the number of elderly (60–74 years) and old (75–90 years) people, as well as long‑livers (over 90 years), is growing year by year. According to leading gerontologists, as reflected in the UN Program on Aging Research in the 21st Century, studying the aging process is not only of theoretical interest but will also help treat diseases of elderly and old people more effectively, increase their life expectancy, and improve its quality.
It has been established that the rate of the aging process of the body as a whole is not the same at different periods of a person’s life; moreover, different organs and systems age at different speeds. Most experts agree that the body of a healthy person reaches optimal parameters of development and function by the age of 25, and from the age of 35 the aging process gains momentum, manifesting as a decline in the body’s capabilities.
Is there a single cause of aging? The answer to this question is negative. Gerontologists have put forward several hundred theories of aging. Many scientists view aging as the result of “accumulation of errors” — irreversible damage to cells over the course of life. One of the most developed such theories is the free‑radical theory.
Free radicals are active chemical particles capable of destroying the normal molecules of our cells. Free radicals are formed in small quantities as an inevitable “by‑product” of metabolism. The level of free radicals increases significantly when the body is exposed to radiation, ultraviolet radiation, toxic substances, as well as in many diseases, including diabetes mellitus.
But our cells are not defenseless against the harmful effects of free radicals: they are neutralized by the antioxidant system. With age, however, the activity of antioxidant enzymes and the content of natural antioxidants in the body decrease. At the same time, the use of antioxidants increases the life expectancy of laboratory animals. A clear example of combating age‑related changes in humans with the help of antioxidants is modern cosmetic products enriched with antioxidant components that protect the skin from free radicals under the influence of the ultraviolet part of sunlight.
The theory of aging due to glycation is also confirmed. Glycation is the irreversible binding of proteins in our cells with glucose. It occurs at a low rate in the bodies of healthy individuals, but in hyperglycemia in patients with diabetes mellitus, it is greatly intensified.
It is sufficient to recall the well‑known glycated hemoglobin, which reflects the average blood glucose level over a period of about 3 months. In a healthy person, its level does not exceed 5%, while in diabetes mellitus it can reach 10–15%. It has been established that even in people without diabetes, the level of such modified “sugar‑coated” proteins increases with age. In diabetes mellitus, glycation disrupts the normal functioning of proteins and often leads to complications — damage to blood vessels and nerves, and clouding of the lens.
With age, hormonal changes also occur in the human body. A typical companion of aging is a decrease in the amount of sex hormones — estrogens and androgens — as well as a deterioration in the biological action of insulin, which regulates, without exaggeration, all aspects of metabolism.
Against this background, the use of carbohydrates by cells decreases, the proportion of fat in the human body increases, especially in the abdominal area. Starting as early as 20–30 years of age, blood cholesterol levels rise, which increases the risk of developing atherosclerosis. The combination of these metabolic disturbances is usually accompanied by an increase in blood pressure and has received the name “metabolic syndrome.”
In metabolic syndrome, the pancreas begins to produce more insulin to prevent an increase in blood glucose levels. When this mechanism is disrupted, type 2 diabetes mellitus develops — a disease that affects people predominantly in the second half of life.
From this, it is clear that aging and diabetes mellitus are closely related: on the one hand, as a person’s age increases, the incidence of diabetes rises; on the other hand, metabolic disturbances in diabetes accelerate the aging of the body.
However, it is obvious that people of the same birth year can differ very significantly in the degree of age‑related changes. In other words, a person’s chronological age does not always reflect the rate of aging. In this regard, the concept of “biological age” was introduced in gerontology.
Measuring biological age allows one to identify an individual “portrait” of age‑related changes in the human body and outline measures to combat them. Scientists began working on this problem more than 70 years ago and have already proposed several dozen methods for determining biological age. Based on the comparison of biological and chronological age, one can judge the pace of aging of the human body.
If biological age is significantly greater than chronological age, we speak of accelerated aging.
· If it is lower, we speak of slowed aging.
· When the two correspond, aging is called physiological.
It should be noted that the value of biological age characterizes the state of the body at the present time and in no way determines the length of future life.
At our endocrinology clinic and the Laboratory of Pathophysiology of Aging at the Hospital for War Veterans, during the period 2001–2005, about 300 patients with diabetes mellitus were examined. All of them underwent laboratory blood tests, and their biological age was determined using a methodology proposed by the Kyiv Research Institute of Gerontology — the leading scientific institution on the problem of aging in the territory of the former USSR.
We found that the biological age of patients with diabetes mellitus often differed from their chronological age: about 50% of patients had an accelerated rate of aging, and the maximum deviation of biological age from chronological age reached 30 years. Such significantly elevated indicators had previously been observed in veterans of armed conflicts who were treated at the hospital.
We studied in detail the indicators of metabolism that are impaired in diabetes mellitus and established that poor compensation of the disease plays a leading role in accelerating the aging of the body.
In diabetic patients with an accelerated rate of aging, in most cases a high level of blood sugar (hyperglycemia) and glycated proteins was determined; signs of increased formation of free radicals were significantly more common, and blood lipid levels were somewhat above normal.
These disturbances were most pronounced in relatively young people — aged 35–50 years — and they also showed the greatest deviation of biological age from chronological age. It should be noted that diabetic patients with an accelerated rate of aging had a significant excess body weight, while in those with a slowed rate of aging, weight only slightly exceeded the norm.
The contribution of diabetes “duration” and complications to the increase in biological age turned out to be less than expected. These data show how important it is for a patient with diabetes mellitus, in cooperation with the treating physician, to fight the disease and achieve normalization of metabolism — that is, compensation of the disease.
Modern gerontology can influence the speed of the aging process through targeted measures: both by taking medications and by non‑pharmacological methods.
Medications that slow down the aging process and extend the life of laboratory animals are diverse: antioxidants (for example, vitamins A, C, E), stimulants of energy metabolism and immunity, vitamins, some hormones, and detoxification drugs.
Special mention deserves the presence of these properties in antidiabetic drugs from the biguanide group (in endocrinology, one of them is now widely used — metformin). All the listed groups of drugs are used in medicine according to indications for use. However, none of these drugs has yet proven the ability to slow down the aging of the human body, and there are currently no grounds to recommend their use specifically for this purpose.
Non‑pharmacological interventions can have no less significant impact on the rate of aging. The most effective of them — caloric restriction — can increase the life expectancy of experimental animals by up to 1.5 times.
At present, a long‑term study of this method is ongoing in the United States in a group of healthy volunteers, and it has already been established that their metabolic parameters are approaching the “ideal” values of young people.
In our Hospital for War Veterans, the ability of hyperbaric oxygenation and “dry” carbon dioxide baths to reduce the biological age of the body has been identified; indications and contraindications for these methods and optimal treatment regimens have been determined.
Our examination of patients with diabetes mellitus demonstrated similar activity in preparations of lipoic (thioctic) acid, widely used in endocrinology for the treatment of diabetic neuropathy.
We would like to conclude the discussion on the relationship between diabetes mellitus and aging with brief recommendations from leading gerontologists. Thus, in order to slow down the development of age‑related changes, one should:
- Maintain a rational work–rest schedule, allocating sufficient time for sleep, including daytime rest, as well as for feasible daily physical exercises.
- Avoid overeating; nutrition may be moderately low in calories but must be balanced in terms of the ratio of proteins, fats, and carbohydrates and contain products rich in fiber.
- Treat stress situations reasonably, quickly switching from negative emotions to positive ones.
- Spend as much time as possible in an environmentally clean area.
- Avoid chronic intoxications, including smoking and alcohol abuse.
- Monitor blood pressure, cholesterol, and blood sugar levels.
- Properly treat existing chronic diseases, and in diabetes mellitus — strive to achieve its compensation.
- For preventive purposes, take courses of multivitamin preparations with antioxidants (vitamins A, C, E, the trace elements selenium and zinc), especially during periods of seasonal deficiency (winter–spring), as well as during periods of intense physical or mental stress.
