Diabetes is a serious medical condition—and its incidence is on the rise. The main symptom of diabetes is elevated blood sugar levels, which causes a process called glycation within the body.
Glycation occurs when a sugar binds a protein. This is the process also known as the “Maillard reaction,” which also occurs when you caramelize onions or turn sugar to caramel. Although it makes foods taste delicious, glycation is damaging to important components in the skin. Elastin gives the skin its elasticity or the ability to bounce back. When sugar binds to elastin through the glycation process, this damages the elastin and it becomes rigid and less elastic. Glycation leads to aged, sagging skin but it also causes damage to many vital organs in the body.
When glycation occurs in the arteries, it makes them rigid, which can cause high blood pressure and impair the heart’s ability to pump blood. Glycation can also damage the eyes, nerves, kidneys and other organs. This is why lowering blood sugar levels to minimize glycation is the primary goal of diabetes treatment. One of the most common medications used to lower blood sugar levels is Metformin; also known as the brand-name drugs Fortamet, Glucophage, Glumetza or Riomet. The medical community is starting to examine whether diabetes medications such as Metformin may reduce visible signs of skin aging like wrinkles, and the answer (for now) is “maybe.”
Glycation and skin aging
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Collagen and elastin are responsible for young skin’s strength, thickness and ability to bounce back. These proteins are found in the dermal layer of the skin known as the “dermis.” When collagen is damaged, skin becomes thin, wrinkled and fragile, while compromised elastin results in decreased elasticity that prevents skin from “bouncing back.” Damaged elastin is abnormally clumped together and nonfunctional when viewed under a microscope, and research has convincingly shown that glycation is to blame.
A 2007 study in the British Journal of Dermatology found that sugar’s effects on the skin begin to show at about age 35 and become more pronounced as we age. And it’s not just the obvious sugary culprits like soda and candy that cause damage. Other foods with a high glycemic index such as white bread, pasta and potatoes also promote glycation because they are quickly converted to sugar in the bloodstream. To make matters worse, the glycation process can be accelerated by unprotected sun exposure.
Eating less sugar, eating and applying more antioxidants, wearing sunscreen daily and avoiding excess sun exposure are the best first steps for minimizing glycation. In addition, weight-bearing exercise such as weight-lifting has been shown to help the body recognize insulin more efficiently and maintain lower blood sugar levels. If you have a tendency for diabetes, see your doctor to have your HbAIc levels checked to see if you need to be on medication to lower your blood sugar levels.
As far as the skin is concerned, there are no topical skincare products or supplements that can help reverse glycation once it occurs, therefore, prevention is the best treatment at this time. Sunscreen, antioxidants (particularly vitamin C) and retinoids can help increase collagen production to counteract the effects of glycation by replacing the damaged collagen with new collagen.
Since diabetes medications such as Metformin lower blood sugar levels, and in turn reduce glycation, it’s definitely possible that they can have an anti-aging effect on the skin as well. Stay tuned for updates!
Dr. Leslie Baumann is a board-certified dermatologist and CEO of Baumann Cosmetic & Research Institute in Miami.