Advanced glycosylated end products derived from external sources contribute to diabetic complications

Advanced glycosylated end products (AGEs) are implicated in the pathogenesis of damaging complications seen in diabetes. They are formed by non‐enzymatic glycosylation, have cross‐linking properties with amino acids and interfere with normal functioning of vascular and other tissues. AGEs arise mostly in the hyperglycaemic milieu of diabetes. Little attention has been devoted to major extraneous sources of AGEs, such as cooked food and other more unexpected products such as cola drinks and instant coffee. Also, tobacco and tobacco smoke give rise to enhanced AGE formation. Most diabetologists and dietitians are unaware of this unwanted contribution to diabetic complications. AGEs formed in heated foods containing protein and fructose are absorbed with a bioavailability of about 10%, and their excretion is increasingly impaired as kidney function decreases. The contribution of exogenous AGEs may be greater than those formed endogenously. New avenues are being developed to reduce the burden of AGEs. Copyright © 2003 John Wiley & Sons, Ltd.