**4. Conclusion**

Our results suggest the relation of glycation and oxidation to profibrotic cytokines, vascular molecules and diabetic complications. Serum AGEs were connected with complications other than retinopathy more than just with retinopathy, nevertheless, some relation of retinopathy and s-AGEs was found (p-values were only slightly higher than 0.05). Lipoperoxides showed some relation to DR since higher in patients with retinopathy than in those with other DC, whereas AOPP did not show any relation to any DC. It seems that in our patients TGF-beta1 and VCAM-1 are linked with the development of DC, but only TGFbeta1 showed some linkage to diabetic retinopathy.

We ought to keep in mind the fact our investigation concerns the children and adolescents. Maybe the study of older patients with T1DM would show more, especially about VCAM-1 and its relation to glycative and oxidative stress and consequently to development of retinopathy/other complications.

## **5. Acknowledgment**

This work is supported by the Vega Grant 1-0375-09 from the Ministry of Education, Sciences, Research and Sport of Slovak Republic. Authors thank Mr. Ľ. Barak, M.D., Mrs. E. Jancova, M.D., Mrs. A. Stanikova, M.D., Mrs. D. Tomcikova, M.D. for assistance with subject recruitment and assessment and Mrs. J. Kalninova, RN.D. and Mrs. E. Tomeckova for technical assistance.

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Our results suggest the relation of glycation and oxidation to profibrotic cytokines, vascular molecules and diabetic complications. Serum AGEs were connected with complications other than retinopathy more than just with retinopathy, nevertheless, some relation of retinopathy and s-AGEs was found (p-values were only slightly higher than 0.05). Lipoperoxides showed some relation to DR since higher in patients with retinopathy than in those with other DC, whereas AOPP did not show any relation to any DC. It seems that in our patients TGF-beta1 and VCAM-1 are linked with the development of DC, but only TGF-

We ought to keep in mind the fact our investigation concerns the children and adolescents. Maybe the study of older patients with T1DM would show more, especially about VCAM-1 and its relation to glycative and oxidative stress and consequently to development of

This work is supported by the Vega Grant 1-0375-09 from the Ministry of Education, Sciences, Research and Sport of Slovak Republic. Authors thank Mr. Ľ. Barak, M.D., Mrs. E. Jancova, M.D., Mrs. A. Stanikova, M.D., Mrs. D. Tomcikova, M.D. for assistance with subject recruitment and assessment and Mrs. J. Kalninova, RN.D. and Mrs. E. Tomeckova for

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**2** 

*1Netherlands 2Germany* 

**Diet, Lifestyle and Chronic Complications** 

Diabetes mellitus is with 220.000 deaths per year the eighth leading cause of death in high income countries (World Health Organization (WHO) 2008)**.** In 2007, over 740.000 people in the Netherlands were suffering from diabetes and this number is expected to grow to 1.3 million people in 2025 (National Institute for Public Health and the Environment (RIVM) 2010). Worldwide approximately 285 million people had the disease in 2010 and this number will increase till 438 million in 2030 (World Diabetes Foundation (WDF) 2010). In 2000, diabetes was most prevalent in India with 31.7 million cases. China (20.8 million cases) and the United States (17.7 million cases) were on the second and third place. Diabetes also has a great economic impact on the individual, nation healthcare system and economy

Type 1 diabetes accounts for 5% of all cases of diabetes worldwide. Of this 5% the vast majority are children. In type 1 diabetes the body does not produce insulin (American Diabetes Association (ADA) 2010).The disease has a strong genetic component, inherited mainly through the HLA complex but the exact cause is unknown. Most likely there is an environmental trigger in genetically susceptible people that causes an immune reaction. The body's white blood cells mistakenly attack the insulin-producing pancreatic β-cells (U.S. National Library of Medicine 2011). Putative environmental triggers include viruses (e.g. enteroviruses), environmental toxins (e.g. nitrosamines) or foods (e.g. early exposure to cow's milk proteins, cereals or gluten) (Daneman D 2006). This 'food' trigger explains why type 1 diabetes is less common in people who were breastfed and in those who first ate solid foods at later ages (Sadauskaitė-Kuehne V et al. 2004; American Diabetes

People with type 1 diabetes also have an increased risk of developing some serious and life threatening complications. This involves acute complications, like hyperglycaemia and hypoglycaemia which can lead to a coma, but also chronic complications (National Institute for Public Health and the Environment (RIVM) 2007). Chronic complications can be subdivided into macrovascular and microvascular complications. Cardiovascular disease is the major macrovascular complication and includes mainly myocardial infarction and stroke (American Diabetes Association (ADA) 2010). The risk for cardiovascular disease, is 4-8

**1. Introduction** 

Association (ADA) 2010).

(International Diabetes Federation (IDF) 2010).

 **in Type 1 Diabetic Patients** 

 *Heinrich-Heine-University Duesseldorf* 

S. S. Soedamah-Muthu1, S. Abbring1 and M. Toeller2 *1Division of Human Nutrition, Wageningen University, Wageningen 2Department of Endocrinology, Diabetology and Rheumatology* 

Zhou, G., Li C. & Cai, L. (2004). Advanced glycation end-products induce connective tissue growth factor-mediated renal fibrosis predominantly through transforming growth factor β-independent pathway. *American Journal of Pathology*, Vol.165, No.6, (December 2004), pp. 2033-2043, ISSN 0002-9440
