August 2, 2003
Other
Question from Northwood, New Hampshire, USA:
A couple of years ago the American Diabetes Association passed on a publication regarding a blood test which determines which type of a certain protein called haptoglobin patients carry in their blood. I understand that those who carry one type have a low risk for developing complications, while those carrying the two other types have much higher risks. These findings were reported in related articles in the September 28, 2000 issue of the New England Journal of Medicine and in the September 13, 2000 Journal of the American Medical Association.
This explains why some patients who have excellent glucose control still suffer from complications while some who have out of control glucose seem to avoid complications because they have the “good” protein. The determination of these findings will benefit patients, since it will allow doctors to threat those at risk for complications more aggressively, while treating more conservatively the minority protected by their haptoglobin type. I’m sure there are others who would be very interested in these findings.
Where can I get my child’s haptoglobin type tested? Has been a drug been developed yet that reduces free radicals?
Answer:
You can get haptoglobin assays done through Quest Diagnostics<>. However, you need to visit the web site to locate the nearest regional laboratory.
The studies to which you referred were really quite limited and were carried out on a small number of elderly subjects with type 2 diabetes. There have been no comparable long term surveys in teenagers; but centers are beginning to monitor other simpler and less expensive markers of vascular inflammation like C reactive protein levels.
Good blood glucose control remains the paramount goal in preventing long term complications in diabetes. However, there are really quite a number of free radical scavengers that are available as diet additives in any supermarket, the best known being vitamins C and E and nicotinamide.
DOB
Additional comments from Dr. Stuart Brink:
These are research studies and not yet available for routine clinical use. You should discuss this, of course, with your diabetes team.
SB
[Editor’s comment: PubMed has articles concerning “haptoglobin+diabetes”; see, for example, Genetically determined heterogeneity in hemoglobin scavenging and susceptibility to diabetic cardiovascular disease.
WWQ]
