How Fasting Glucose is Your Best Defense against Aging

Here’s What You Can Do About It

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My Longevity Experiment
January 06, 2025

How to Slow Aging: Insights from Diabetes and Epigenetic Clocks

A recent study published in Aging Cell has provided further evidence supporting the link between type 2 diabetes and accelerated aging. Researchers have focused on understanding this relationship through advanced biological aging measurements, particularly epigenetic clocks. These tools, such as GrimAge, PhenoAge, and DunedinPACE, allow scientists to quantify age acceleration at the molecular level. By filtering out noise, these "principal component" versions of epigenetic clocks yield more robust and reliable results than earlier generations.

Type 2 Diabetes and Aging: A Causal Connection?

Previous studies have suggested an association between type 2 diabetes and accelerated aging. For example, the DunedinPACE clock, originally trained on Western populations, demonstrated similar findings in Taiwanese individuals. Earlier research by the same team also identified correlations between diabetes and aging metrics across different biological clocks. Importantly, some studies have pointed toward a causal relationship—indicating that diabetes itself may actively accelerate aging. The current study aimed to provide stronger evidence for this connection.

Data from the Chinese National Twin Registry

The study utilized data from the Chinese National Twin Registry (CNTR), comprising 535 pairs of twins, including 380 identical pairs. Among these, 157 twin pairs (95 identical) had both baseline and follow-up data spanning four to five years. Researchers measured diabetes-related markers such as fasting glucose and HbA1c while accounting for confounding factors, including smoking, education, BMI, alcohol consumption, and exercise. This comprehensive dataset enabled both cross-sectional and longitudinal analyses.

Key Findings from the Study

The average age of participants was 50 years, with 10% meeting the glycemic criteria for type 2 diabetes at baseline. Among those with follow-up data, the prevalence of type 2 diabetes rose from nearly 12% to 17% over time. The cross-sectional analysis revealed strong associations between specific diabetes markers and age acceleration, as measured by the three clocks, particularly PhenoAge.

For instance, individuals with elevated HbA1c levels exhibited an average of three additional years of aging according to PhenoAge. Fasting glucose also demonstrated a robust association with age acceleration. While diabetes itself showed weaker associations and did not achieve statistical significance across the clocks, other metrics provided compelling evidence.

Longitudinal and Cross-Lagged Insights

The longitudinal analysis offered limited new insights, but a cross-lagged analysis comparing baseline and follow-up measurements revealed critical findings. Higher baseline levels of fasting glucose, HbA1c, and triglyceride-glucose (TyG) indices predicted increased age acceleration on the DunedinPACE clock at follow-up. Similarly, the TyG index was linked to higher age acceleration on GrimAge.

Stratified analyses showed significant associations in men and individuals with lower education levels, but reduced sample sizes in these subgroups limited statistical power. The inclusion of identical twin pairs mitigated genetic variability, although the relatively small sample size of twins with longitudinal data also constrained the study’s statistical strength.

Notable Conclusions

Despite limitations, the researchers highlighted two significant conclusions:

  1. DunedinPACE exhibited unique sensitivity to glycemic metabolism, distinguishing it as a valuable tool for studying diabetes-related aging.

  2. The observed effects were independent of blood cell composition, reinforcing the robustness of the findings.

While the study supports the idea that diabetes accelerates epigenetic aging, it stops short of offering definitive proof. The researchers call for further studies to replicate and expand upon these results.

Broader Implications

A 2019 study underscores the severe consequences of diabetes, linking it to premature death through a range of morbidities, including cardiovascular disease. Prominent figures in the longevity field, such as David Sinclair, have highlighted the importance of managing diabetes risk. Sinclair has referred to diabetes as a “gateway condition” that predisposes individuals to other age-related diseases. He has cited this rationale for taking metformin as a preventative measure, even among those who are not diabetic but are at risk of developing the condition.

The findings of this study underscore the importance of managing glycemic health as a key strategy for slowing aging and mitigating the onset of age-related diseases. As research continues to unravel the complex interplay between metabolic conditions and aging, individuals may benefit from proactive lifestyle and medical interventions.

Berberine as an Alternative to Metformin

Berberine, a natural compound extracted from plants like Berberis, has gained attention for its potential to control blood sugar levels effectively. It works by activating AMP-activated protein kinase (AMPK), a key enzyme that regulates metabolism, improving insulin sensitivity and glucose uptake in cells. Studies suggest that berberine reduces fasting blood glucose, HbA1c levels, and insulin resistance, making it a promising option for managing type 2 diabetes. Additionally, it may help reduce the production of glucose in the liver and improve gut microbiome health, further supporting blood sugar regulation. As a natural supplement, berberine offers a complementary approach to traditional treatments.

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Study Links:

[1] Lin, W. Y. (2023). Epigenetic clocks derived from western samples differentially reflect Taiwanese health outcomes. Frontiers in Genetics, 14, 1089819.

[2] Lo, Y. H., & Lin, W. Y. (2022). Cardiovascular health and four epigenetic clocks. Clinical Epigenetics, 14(1), 73.

[3] Kong, L., Ye, C., Wang, Y., Hou, T., Zheng, J., Zhao, Z., … & Wang, T. (2023). Genetic evidence for causal effects of socioeconomic, lifestyle, and cardiometabolic factors on epigenetic-age acceleration. The Journals of Gerontology: Series A, 78(7), 1083-1091.

[4] Palmer, A. K., Gustafson, B., Kirkland, J. L., & Smith, U. (2019). Cellular senescence: at the nexus between ageing and diabetes. Diabetologia, 62, 1835-1841.