Are Both Types of Diabetes an Autoimmune Disease?
What exactly causes insulin to become compromised? While diabetes is mostly attributed to an unhealthy weight and lifestyle choices, it may just be related to or considered an autoimmune disease.
Diabetes is an umbrella term to describe the phenomenon in which the body is unable to utilize glucose from carb sources, mostly related to the absence or resistance of insulin. Insulin can be thought of as a key holder to the cells, allowing glucose to exit the bloodstream and enter into cells for energy use. Without insulin or the "key," glucose (the body's primary source of energy) starts to build up in the blood, hence having "high blood glucose" or "high blood sugar." But what exactly causes insulin to become compromised? While diabetes is mostly attributed to an unhealthy weight and lifestyle choices, it may just be related to or considered an autoimmune disease.
Is Diabetes an Autoimmune Disease?
Well, partly. Diabetes is further broken down into two varying types, also known as a type 1 and type 2 diabetes. Type 1 diabetes is an autoimmune disease, a condition in which the body's own immune system destroys normally healthy cells. So in the case of type 1 diabetes, cells responsible for producing insulin (also known as beta cells from the pancreas) are destroyed, subsequently negotiating the ability for the cells to utilize glucose. Due to the complete loss of insulin produced from beta cells, insulin therapy via injection or infusion pumps are required along with careful, close attention and monitoring. In fact, without insulin administration, ketoacidosis and death are at high risk.
So, Is Type 2 Diabetes an Autoimmune Disease?
In a nutshell, type 2 diabetes is related to insulin resistance, a condition in which cells do not use insulin effectively which causes blood sugars to rise. Type 2 diabetes is mostly developed in individuals who are overweight or obese, likely due to lifestyle choices such as poor diet and inactivity. And unlike type 1 diabetes, most individuals do not rely on insulin and the condition may even be reversible, particularly when weight is lost and maintained in a healthy range.
But while weight was mostly on the forefront of insulin resistance and type 2 diabetes, available data questions whether or not it may just be an autoimmune disease. In fact, the American Diabetes Association suggests there may be an autoimmune component in the upbringing of obesity-linked insulin resistance and type 2 diabetes. The two metabolic pathways in which this phenomenon may occur is related to the changes in metabolic tissues following fat accumulation and the alteration of gut microbiota and mucosal immunity, potentially triggering inflammatory responses in the body and initiating an autoimmune response. "Fat is inflammatory," says Dr. Caroline Cederquist, founding physician of bistroMD. "Fat cells and tissues release chemicals called adipocytokines, which cause swelling and inflammation in the body tissues. Chronic inflammation is definitely linked to autoimmune disease development, though the pathology of this is unclear."
Clinical Presentation and Diabetes Management
Though type 1 diabetes can occur at any point of the lifespan, most cases are diagnosed in ages 30 or younger and mostly between 10 to 15 years of age. Type 1 diabetes accounts for 5 to 10 percent of all diagnosed cases of diabetes, with type 2 engulfing the largest portion of diabetes at 90 to 95 percent. Common signs and symptoms between the two include hyperglycemia, fatigue, excess thirst, and frequent urination. And unlike overweight and obesity being a strong risk factor for type 2 diabetes, type 1 may present itself with unintentional and significant weight loss, along with electrolyte imbalances. If you experience any of the signs and symptoms, are considered overweight, have a history of heart disease, or family history of diabetes, careful screening can further detect risk of presence of diabetes.
Diabetes management is mostly dependent on the type, as type 1 diabetes relies on insulin whereas type 2 mostly does not. Additional management considerations include ongoing self-management and scheduling and attending regular doctor checkups. Careful supervision can ultimately lessen the risk of further complications, including heart disease, kidney disease, retinopathy, and neuropathy just to name a few. Ultimately, both conditions can benefit from a healthy diet and exercise with a common goal primarily including keeping blood sugar levels within an appropriate range, along with managing blood pressures and lipids.
Reduce Diabetes Risk with bistroMD
"To help prevent the development of diabetes, making sure that your body's immune system is strong by giving it a variety of balanced foods will go a long way," says Dr. Cederquist. "Balanced foods will benefit your health in many other areas too. You can empower your immune system greatly by losing weight, eating a variety of colorful fruits and vegetables, as well as making sure you get plenty of sleep and regular exercise."
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