In this revealing episode of the College of Glycation series, Dr. Paul Reynolds—Professor of Cell Biology and Physiology—unpacks the dangerous biochemical spiral that links glycation to diabetes and its devastating complications. If you or someone you love is managing diabetes, this deep dive into the science of sugar-related damage could change the way you think about blood sugar forever.
At the heart of this episode is the concept of glycation, a non-enzymatic process where sugars bind to proteins and fats, creating toxic compounds called advanced glycation end products (AGEs). These AGEs build up in tissues, where they stiffen blood vessels, impair nerves, and ignite inflammatory damage through the AGE-RAGE pathway. And in the context of diabetes, their impact is even more severe.
Dr. Reynolds explores how chronic high blood sugar in both type 1 and type 2 diabetes accelerates AGE formation—leading to neuropathy, retinopathy, nephropathy, and worsening insulin resistance. Drawing on recent studies and clinical insights, he explains how these molecular assaults drive diabetic complications and create a self-reinforcing feedback loop that’s difficult to break.
From the history of glycation research to today’s cutting-edge tools like skin autofluorescence (SAF), this episode provides both a scientific foundation and practical takeaways. Dr. Reynolds highlights dietary strategies, AGE-lowering cooking methods, and promising therapies that may help interrupt the vicious cycle of glycation and insulin resistance.
Topics Covered:
-What glycation is and why it's central to diabetes pathology
-The role of AGEs in diabetic complications: neuropathy, retinopathy, nephropathy
-How insulin resistance and high blood sugar feed glycation damage
-The AGE-RAGE axis: inflammation, oxidative stress, and tissue injury
-Non-invasive tools like skin autofluorescence to track glycation
-Evidence-based ways to reduce AGE burden through diet and lifestyle
-The rising danger of early-onset glycation in younger diabetic patients
Timestamps:
00:00 – Welcome & Introduction
00:39 – Glycation, AGEs, and Insulin Resistance
01:21 – What Is Glycation? A Refresher
02:02 – AGEs: Accumulation and Consequences
02:41 – The History of Glycation Research
03:21 – Glycation’s Role in Diabetic Tissue Damage
04:02 – High Blood Sugar and AGE Acceleration
04:43 – Complications: Neuropathy, Retinopathy, Nephropathy
05:23 – Collagen Cross-Linking and Tissue Stiffness
06:03 – RAGE Receptors and Inflammation
06:45 – Insulin Resistance: The Vicious Driver
07:22 – Mitochondrial Misbehavior from Glucose Spikes
08:02 – Pancreatic Overload and Insulin Burnout
08:42 – Metabolic Chaos and Cellular Dysfunction
09:25 – Insulin Glycation and Mitochondrial Damage
10:06 – HbA1c and Skin Autofluorescence
10:48 – A1C Thresholds: Pre-diabetic vs Diabetic
11:34 – AGEs Predict Diabetic Complications
12:19 – Understanding Neuropathy in Diabetes
13:03 – Myelin, Axons, and Nerve Damage from AGEs
13:41 – Oxidative Stress and Nerve Fiber Loss
14:24 – Neuropathy’s Risk: Falls, Infection, Amputation
15:05 – Retinopathy: How Diabetes Affects Vision
15:48 – AGE Damage in Retinal Blood Vessels
16:31 – Blood-Retinal Barrier and Fluid Leakage
17:19 – Systemic Effects: More Than Just Nerves and Eyes
17:57 – Cardiovascular Risk from Glycated Arteries
18:37 – The Hidden Risk in “Just Pre-Diabetic” A1C
19:17 – Kidney and Liver Damage via AGEs
19:59 – Historical Research Milestones
20:42 – Skin Autofluorescence as Non-Invasive AGE Marker
21:23 – Anti-Glycation Strategies: Polyphenols & More
22:03 – Dietary AGEs and Processed Food Warnings
22:44 – Global Surge in Type 2 Diabetes
23:29 – Early AGE Build-Up in Younger Diabetics
24:10 – Final Takeaways: How to Break the Cycle
24:53 – Lifestyle, Nutrition & Hope for the Future
Whether you’re managing type 1 or type 2 diabetes, trying to prevent long-term complications, or simply want a better understanding of the molecular battle happening inside your body, this episode will leave you informed and empowered.
About Dr. Paul Reynolds
Dr. Reynolds is a biomedical scientist and celebrated educator at Brigham Young University. His College of Glycation series translates complex metabolic science into actionable insights, helping individuals understand and counteract the hidden damage of diabetes and aging.
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