Is Type-2 Diabetes an Inflammatory Disease?
This is not a new theory. Inflammation in the human body can be a devastating process and is believed to contribute to most diseases known to man. This is a nice summary of the link between inflammation and Type 2 diabetes.
The 82nd Annual Meeting of the Endocrine Society Dr. Steven Shoelson of the Joslin Diabetes Center, Boston, Massachusetts, presented the first lecture entitled, “The I-kappa B Kinase Mediates Insulin Resistance in Diabetes and Obesity.”[1] The provocative question at the outset was — is type-2 diabetes an inflammatory disease? Certainly, patients with type-2 diabetes exhibit circulating markers of an “acute phase response,” and some of these, such as tumor necrosis factor-alpha, may contribute to the pathophysiology of type-2 diabetes. However, is there a rationale for treating type-2 diabetic patients with anti-inflammatory drugs? Dr. Shoelson gave historical evidence — dating from 1876, but “rediscovered” as recently as 40 years ago — that high doses of aspirin (ASA) of the order of 10 g per day can attenuate hyperglycemia quite markedly. The Joslin investigators hypothesized that I-kappa B kinases (IKKs), key regulators of the NF-kappa B pathway of proinflammatory signaling, might be the target of ASA, since this dose is known to inhibit their activity. (Of note, much smaller doses are needed to inhibit the cyclooxygenase enzymes that are generally the target of ASA’s anti-inflammatory actions, but these doses of ASA do not appear to affect glycemia.)