How does the body repair extracellular damage caused by glucose? So we know that glucose is an aldehyde that can cause cell damage to the lysine and arginine residues on proteins through the Maillard Reaction (among other damaging reactions that glucose participates in). Since everyone needs glucose to survive, though - I'm wondering - how does the body repair damage to its proteins+blood vessels that are caused by all this glucose? I'm especially interested in the blood vessels, as the damage to blood vessels is common in diabetics.

The Wikipedia article on "Advanced Glycation Endproducts" (or AGE) is quite nice and in this case especially the section on "Clearance", which also contains a few references. In short the AGE which are inside of cells are taken up by the lysosome and then broken down until AGE-amino acids are left. These are secreted into the blood stream and excreted with the urine. Bigger extracellular AGE which cannot pass through the cell membrane are taken up by special receptors first and then processed, here macrophages and Kupffer cells are included. An involvement of the liver is also discussed.

The following articles are also interesting:

* Advanced glycation end-products: a review
* The biology of the receptor for advanced glycation end products and its ligands
* Pathogenic effects of advanced glycosylation: biochemical, biologic, and clinical implications for diabetes and aging.