For several years now, researchers have been looking at Type 2 diabetes as a possible “inflammatory disease.” I first got intrigued by this concept at the big ADA Conference in June this year, and by reading fellow D-blogger David Mendosa’s coverage thereof.
What exactly intrigued me? A couple of interesting things:
* First, I wasn’t even sure what “inflammatory” means in this context. I thought inflammatory diseases were strictly those that affect your joints, like arthritis. It turns out that white blood cells and “inflammatory messengers” including complex fatty acids act like security guards in our bodies, and are essential to our health. Inflammatory disease comes about when the body overreacts or attacks itself instead of a legitimate target, like an infection.
Inflammatory Cytokines (Image courtesy of R&D Systems)
* What this means — and this is the big shift in medical thinking — is that Type 2 diabetes may also be an immune system disorder. There appear to be “imbalances in cytokines, an immune system component that causes inflammation.” This inflammation seems to explain the prevalence of Type 2 diabetes better than increasing obesity in this country, for example, because clearly there are many, many overweight people who do not develop diabetes.
* If this inflammation syndrome could be blocked, it may halt the development of insulin resistance. And if this line of thinking is in fact correct, it may mean that the cure for Type 2 diabetes also lies in “unlocking the mysteries of the immune system.”
* At least one prominent researcher at the Joslin Diabetes Center in Boston, Steve Shoelson, is looking into whether anti-inflammatory drugs can help combat diabetes, and the whole triad of “metabolic syndrome” (the combination of Type 2 diabetes, obesity and heart disease).
Could all of this mean more research efforts and dollars towards auto-immunity and diabetes? Good news for us Type 1s as well. Not only that, but you can hardly throw a pebble in this country without hitting someone suffering from one or more of the components of metabolic syndrome. They’re huge killers, so any progress towards clipping them is good. But of course it’s not all about just popping pills, be they for inflammation or other root causes:
These drugs can work in concert with lifestyle changes to help prevent disease, researcher Shoelson says. “We need to return ourselves to the exercise levels and diet that people had centuries ago.”
Sage advice. Nevertheless, per David Mendosa: “We are just beginning to realize the huge role that reducing inflammation can play in getting control of diabetes.”
Good stuff. Thanks for sharing.
Great insight into a possible future of well thought out research.
Awesome, some major, up to date things I can use when I tell people that some type 2 cases may be an immune system problem! I read an article about the innate immune system and type 2 a year or so ago and kind of latched onto it because it seemed to make a lot of sence. Unfortunately all the info available that I could get to was several years old. Good that it didn’t fall by the wayside and they are still going down this route. Hopefully it will help in the understanding of all forms of diabetes within the medical community and also the face of type 2 to the general public.
This is why eating healthy foods helps T2 so much because the right foods have anti-inflammatory properties-
As I understand it, the auto-antibodies in type 1 are very specific. There is not generalized inflammation and immune activation beyond the initial destruction of the beta cells, although as we know high blood sugars can create a state that induces damage to the endothelium. But that is a sequela of the disease, not the cause of it.
From what I understand, the inflammation that we’re talking about in type 2 is of a qualitatively different nature than the auto-antibodies that cause type 1 in the first place.
Amy: There are not many many people who are not overweight who develop Type 2 diabetes. Antibody testing of the 20% of people diagnosed with Type 2 who are not overweight indicates that more than half of those people have been misdiagnosed and actually have slow onset Type 1 diabetes (LADA) based on the presence of antibodies indicative of Type 1. So actually very few people who have true Type 2 diabetes are not overweight or obese. As you know, people with adult onset Type 1 diabetes are routinely misdiagnosed as having Type 2, strictly based on age not etiology.
@ Melitta: you misread that sentence. It actually says “there are many, many overweight people who do NOT develop diabetes.” So obviously, just being overweight is not the cause. That was the point here…
@ Lauren K: yes, two DIFFERENT TYPES of autoimmune issues…
Thanks all, for your input.
Generalized inflammatory processes are not “auto-immunity.” Only Type 1 involves auto-immunity. It is classified as a type 4 hypersensitivity reaction.
Type 2 does not involve an auto-immune process. Inflammation is the immune system over-reacting to cell damage. Auto-immunity means the immune system reaction is triggered by an protein that should be recognized as “self,” but is mistakenly identified as “foreign.”
Inflammation does not equal auto-immunity, according to everything I’ve been taught. The two should not be confused.
please help the diabetic with their various needs and supplies. we are a growing number of people and need to have some help out here. Many are doing without the proper medical care and supplies due to lack of finances and lack of knowledge.
Joan KLine
This is an interesting finding and correlates well with other findings linking poor dental hygiene and the inflammation of gingivitis with higher rates of diabetes.
This is an interesting finding and correlates well with other findings linking poor dental hygiene and the inflammation of gingivitis with higher rates of diabetes.
I have diabetes, but I know plenty of people a lot fatter than me who don’t, because it does NOT run in their family, I am a FIRM believer in GENETICS, and you are more likely to get ANYTHING, from cancer to obesity if it is in you family. You could not argue that fact with me, sorry
I eat healthier than the majority of america and excercise, because of the diabetes, but no one is going to tell me I got diabetes because I am a fat lazy slob ( I have also lost about 70 lbs as well)
I have type 2 diabetes. This may explain when I am on prednisone for my asthma, my blood sugar is near optimum (90 -130) on the last couple days of the treatment when I am on the lowest doses, but when I finish the prednisone, I am back to 150-180. My diet hasn’t changed, my activity level hasn’t changed (if anything I am more active since my asthma is under control again), the prednisone is usually the only factor.