Inflammation is a healthy response to infection or injury. It’s the way that our immune system activates to respond to injury, or to internal offenses like viruses, bacteria, or toxic chemicals. This response is called acute inflammation and it starts the healing process.

But sometimes the body sends out inflammatory cells when we’re not sick or injured. Those same inflammatory cells can turn on our bodies, attacking healthy tissue. This type of aberrant immune response is involved in the disease process of several conditions, including Alzheimer’s disease, asthma, cancer, heart disease, rheumatoid arthritis, systemic lupus, and, yes, diabetes. 

If you have type 1 or type 2 diabetes, you are likely dealing with some level of chronic inflammation that could possibly lead to health complications beyond diabetes itself. This article will help provide an understanding of how inflammation is connected to diabetes and how it might be treated.

Type 1 Diabetes and Inflammation

Type 1 diabetes is caused by an autoimmune attack on the pancreas, destroying its ability to secrete insulin. Immune system cells cause beta cell death in a variety of ways, including by provoking inflammation. Some researchers have called type 1 diabetes “a chronic anti-self-inflammatory response,” and there is a theory that inflammation in the pancreas may help cause type 1 diabetes in the first place. 

Once type 1 diabetes has developed, it also causes inflammation elsewhere in the body, perhaps a result of the way the immune system reacts to excessive glucose levels. According to researchers at the Medical College of Georgia at Augusta University, the immune system reacts by sending out inflammatory cells, which over time can contribute to the destruction of organs, nerves, and blood vessels. 

A 2017 study by Italian researchers, for example, suggested that people with type 1 diabetes experience inflammation in the digestive tract:

“Our findings indicate the individuals with type 1 diabetes have an inflammatory signature and microbiome that differ from what we see in people who do not have diabetes or even in those with other autoimmune conditions such as celiac disease,” said the study’s senior author, Lorenzo Piemonti, MD, of the Diabetes Research Institute at San Raffaele Hospital in Milan, Italy. 

How to Treat Inflammation in Type 1 Diabetes

Researchers are hard at work on experimental type 1 diabetes therapies that specifically target inflammation. For the same reason, anti-inflammatory drugs may eventually play an important role in the development of a cure for the condition. But at the moment, though there are a variety of drug treatments available for chronic inflammation, these medications are not commonly prescribed for type 1 diabetes. Some, such as the steroids used to treat rheumatoid arthritis, may be inappropriate for diabetes due to a profound glucose-elevating effect.

For now, it appears that the best way to address inflammation is through prudent diabetes management. Insulin has a strong anti-inflammatory effect in type 1 diabetes. A 2013 study at the University at Buffalo’s Jacobs School of Medicine and Biomedical Sciences found that while even small amounts of glucose result in profound inflammation, insulin suppresses the pro-inflammatory protein HMGB1. Insulin doesn’t fix the problem — insulin’s anti-inflammatory effect takes three times as long in people with type 1 diabetes — but the study helps reinforce the importance of taking the right amount of insulin with meals. Keeping your blood sugars in range should also help limit chronic inflammation.

Chronic inflammation can also be improved through better lifestyle decisions — including healthy diet and exercise — according to Harvard Medical School.

Type 2 Diabetes and Inflammation

Type 2 diabetes also has a complex two-way relationship with inflammation. Type 2 diabetes, which is defined by insulin resistance, can lead to chronic inflammation, which in turn causes more insulin resistance. It’s a vicious cycle.

Chronic and systemic inflammation are prominent features of type 2 diabetes. The condition creates an excess of cytokines, signaling proteins that help control inflammation, which can lead to excess inflammation. Obesity also provokes inflammation, stimulating the release of inflammatory mediators, including interleukin-6, a cytokine, and reduced production of adiponectin, a hormone that helps address insulin sensitization and anti-inflammatory effects. Reduced levels of adiponectin can lead to type 2 diabetes development.    

Chronic inflammation contributes to diabetes complications, including diabetic peripheral neuropathy, nerve damage that tends to begin in the feet or hands. Other potential issues include heart failure, diabetic retinopathy, and musculoskeletal problems like muscle and joint pain or stiffness. 

How to Treat Inflammation in Type 2 Diabetes

Several diabetes medications have anti-inflammatory properties, including statins, anti-diabetic agents like insulin, and metformin — drugs you may already be taking. GLP1 receptor agonists (including Ozempic) and SGLT2 inhibitors — probably the two most important newer classes of type 2 diabetes medication —  have intrinsic anti-inflammatory properties, according to a 2019 Greek study, though it’s unclear how much they contribute to actual inflammation reduction. 

Responsibly using diabetes drugs, as prescribed by your doctor to help achieve good glucose control, is likely one of the best ways of stopping chronic inflammation from getting out of hand.

In the future, there may be more targeted treatments available. Some researchers subscribe to the “inflammation theory” of type 2 diabetes and believe that attacking inflammation directly will lead to improved glucose control. However, much more experimentation needs to be done before any such therapies are available.

Another ideal way to address chronic inflammation is through healthy lifestyle decisions. Exercise has a powerful anti-inflammatory effect. A wholesome diabetes diet, one emphasizing whole foods and avoiding processed sugars and starches, can also improve inflammation. Some experts have even designed special anti-inflammatory diets that include foods with antioxidants like fatty fish, fruits, vegetables, herbs, and spices.

Managing type 2 diabetes well — with good diet and exercise habits, and the prudent use of medications — is likely the best way we have to fight against chronic inflammation’s negative health effects.

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Read more about autoimmune disease, beta cells, complications, diabetes complications, Diabetes Research Institute (DRI), exercise, immune system, inflammation, insulin, Intensive management, metformin (Glucophage), neuropathy, retinopathy, SGLT-2.

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