“Is diabetes an autoimmune disease?” is a question most people want the answer to.
Before getting into that topic, let us first of all, get to know all about diabetes. We all see that more and more people have diabetes. According to the World Health Organization, about 422 million people in the world have diabetes, the majority living in low- and middle-income countries, and around 1.5 million people die because of diabetes each year.
Not only adults but also children and adolescents develop diabetes. What may be the reason? Also, what is the confusion? Are all diabetes types auto-immune diseases? Read further to get a clear idea.
1. Diabetes
Diabetes is a longstanding condition of the body’s natural chemical processes that affect how food is converted into energy. It is a metabolic disease that disrupts the body’s natural metabolism on a cellular level. It stops the pancreas from producing a hormone, insulin, which maintains the sugar level in our blood. As a result, blood sugar level goes up, and this health condition is called diabetes.
Humans require energy to work, which comes from the food we eat. Our bodies break down food by mixing it with acids and enzymes in the stomach. When the food is digested in the stomach, carbohydrate-containing sugars and starches are digested into one more type of sugar, glucose.
The stomach, along with the small intestines, absorbs the glucose before releasing it into the bloodstream. This glucose is the energy supply our body needs to perform activities. So this glucose is either used immediately or stored in the liver, muscle T cells, and other tissues as glycogen to be used later.
Regardless, insulin is a must for our body to either use or store glucose. If insulin is not produced, glucose remains as such in the bloodstream, keeping up the blood sugar levels. Insulin is a hormone secreted by fat cells in a gland behind our stomach known as the pancreas. The pancreas contains insulin-producing cells called beta cells(β-cells). β-cells continuously check the blood sugar level and produce insulin corresponding to the body’s needs.
1.1 Types of Diabetes:
Type 1 and type 2 diabetes are the names of high blood sugar caused by different factors. They both may share a similar name, yet they differ in how and why they affect our bodies.
1.1.1. Type 1 Diabetes mellitus:
Originally known as juvenile-onset diabetes, type 1 diabetes occurs when the body’s immune system destroys the cells responsible for insulin production. It was found that type 1 diabetes occurs because of auto-immune aspects when immune system cells promote insulin resistance due to cell-mediated immune responses.
Type 1 diabetes causes heightened blood glucose, primarily due to insulin resistance. This condition happens when cell responses are weak and unable to absorb enough insulin.
Around 5 to 10% of cases of diabetes mellitus are type 1. Moreover, there is Latent Auto-immune Diabetes, which is a subtype of type 1 diabetes. It is also known as latent autoimmune diabetes in adults (LADA) and is frequently mistreated. LADA results from the pancreas gradually ceasing to produce enough insulin.
1.1.2. Type 2 diabetes mellitus:
It was formerly called non-insulin-dependent or adult-onset diabetes. Approximately 90% of diabetes patients suffer from type 2 diabetes mellitus. Type 2 diabetes begins as insulin resistance initially. Gradually, insulin becomes ineffective, and the production of insulin increases to prolong the state of homeostasis.
However, insulin production goes down over time. Typically, people over 45 develop insulin resistance and this type 2 diabetes. But it is also seen in children, adolescents, and younger adults due to rising levels of obesity, physical inactivity, and unhealthy lifestyle.
1.1.3. Type 3 diabetes
Gestational diabetes, also called Hyperglycaemia, occurs during pregnancy. In accordance to the American Diabetes Association (ADA), type 3 diabetes can be found in 7% of all pregnancies. Women with gestational diabetes and their children have an increased risk of developing type 2 diabetes mellitus in the future.
2. Auto-immune Diseases
Auto-immune diseases are disorders caused when immune cells of the body and the immune system mistakenly attack the body’s normal cells. This immune reaction targets healthy tissues and cannot differentiate between foreign and the body’s cells. It affects various organs.
Examples of auto-immune disorders or diseases include type 1 diabetes, rheumatoid arthritis, inflammatory bowel disease (IBS), autoimmune thyroid disease, multiple sclerosis, and psoriasis. Patients employ multiple methods to treat auto-immune diseases. They take painkillers, immunosuppressive meds, and anti-inflammatory medications. Many choose to have blood transfusions, hormone replacement therapy, and physical rehabilitation when necessary.
To learn more about auto-immune diseases, click here.
3. Is Diabetes an Autoimmune Disease?
There is a discussion on the matter of whether type 2 diabetes is an auto-immune disease or not. Type 1 diabetes has been established as an auto-immune disorder, while type 2 diabetes is considered a metabolic disorder. But, claims are made that there isn’t as much difference between diabetes type 1 and type 2 as we think. Type 2 diabetes may also be an auto-immune disease.
3.1 What Makes Type 1 Diabetes an Auto-immune Disease?
Type 1 diabetes and LADA are auto-immune conditions that cause a person’s body to attack its normal cells. In type 1 diabetes, as an endocrine disorder, the insulin-producing pancreatic beta cells (β-cells) are destroyed by autoreactive t-cells. B cells also assist insulin resistance by modulation of t cells and producing pathogenic IGG antibodies.
On the one hand, β-cells are present in the pancreas within the cluster of cells called islets. They produce a hormone called insulin which controls the sugar content in the blood. On the other hand, T cell lymphocytes, a type of leukocyte (white blood cell), play a significant part in cell-mediated immunity that includes immune cells attacking the foreign cells to avoid infection.
The function of T cells is to actively destroy infected cells while also signaling other cells in the immune system to join them. Granting that the type 1 diabetes onset is found in a person, β-cells are attacked by t cells, making it an auto-immune disease.
3.2 What Makes Type 2 Diabetes Mellitus an Auto-immune Disease?
The onset of type 2 diabetes mellitus can be caused by chronic inflammation-induced disruption of the insulin signaling system. Type 2 diabetes and obesity-related insulin resistance are linked to long-lasting, subclinical inflammatory responses that reduce the effectiveness of insulin in most healthy tissue and may also affect pancreatic beta-cell function.
The occurrence of this inflammation suggests an innate immune response. Yet, recent information suggests that the adaptive immune system’s aspects might be responsible, which could mean auto-immune disease development. So, theories have come up to say that there’s a chance that type 2 diabetes can be an auto-immune disease.
4. How Does Diabetes Affect You?
In splenocytes, the insulin-producing molecule is destroyed, and subsequently, the cell relies on glucose to make the molecule work better. A complete loss of insulin from β-cells may require insulin resorption through injectible pumps and careful monitoring. Consequently, ketoacidosis is severe, especially if you have type 1 diabetes.
Diabetic ketoacidosis, also called DKA, is fatal when the liver converts fat to energy, producing a high level of ketones (acids), as there’s no insulin. DKA can lead to death or coma, as ketones are poisonous if generated too much. Usually, anyone with diabetes may be affected, although it is uncommon in people with type 2 diabetes.
People with Type 1 diabetes may also develop other auto-immune diseases, especially thyroid diseases like thyroid autoimmunity (Hashimoto’s disease) and celiac disease. Associated antibodies are also usually found among patients, sometimes clashing with overt but often subclinical disease. Moreover, it was shown that type 1 diabetes patients have more chances of acquiring gastric autoimmunity, vitiligo, and adrenal gland insufficiency.
HHS, or Diabetic hyperglycemic hyperosmolar syndrome, is also an effect of type 2 diabetes, where the blood glucose levels are high for an extended period. However, no ketones are produced in this case. Symptoms of HHS include dehydration, frequent urination, and confusion.
It can create complications such as seizures, coma, organ failure, and even death. The other risk factors of diabetes include damage to the:
- Heart
- Liver
- Eyes
- Blood vessels
- Kidney
- Nerves
It may also result in heart attacks, strokes, foot ulcers, infections, kidney failures, etc.
5. What Makes the Immune System React This Way?
In some instances, the reason for the onset of the autonomic disease has not been identified. However, other possibilities could help explain this malfunction. When our natural defense system fails, we start triggering an auto-immune response. Sometimes healthy cells can get trapped.
Identifying auto-immune conditions that are common genetic factors, usually found in families, predominantly in women populations, is possible.
Injury plays a role in auto-immune disorders too. During stress, some parts of our bodies are susceptible to the response. Since these auto-immune diseases can destroy healthy cells, they could easily interfere with organ functions and cause rashes, fatigue, nausea, and more.
6. Diabetes Management
Diabetes management and treatments include eating a healthy diet and living an active life. Increase the number of fruits, vegetables, lean proteins, and whole grains in your diet. These are nutrient-dense foods with a high fiber content and low in fat and calories.
Furthermore, you should consume fewer sweets, processed carbohydrates, and saturated fats.
Exercising regularly is required to manage a healthy life and fight against insulin-resistant cells. Your blood sugar level is sometimes lowered by exercise. This is done by allowing sugar to enter your cells, where it is converted to energy. Your body will have good insulin sensitivity when you exercise, meaning your body requires less insulin to control the blood sugar level.
So try to be active for at least 150 minutes weekly or 30 minutes or more of moderate activity most days. You can also do highly intense workouts for a brief time throughout the day. It is advised to limit your sitting time. If you have been sitting for more than 30 minutes, try to stand up and move around.
7. Treatment for Diabetes
Diabetes treatments include insulin injections or pumps, sugar checks, and carbohydrate calculations. For type 1 diabetes, a pancreas transplant or islet cell transplant may also be an option. Mainly, people with type 1 diabetes need insulin to survive.
Treatment of type 2 diabetes requires lifestyle changes, continuous sugar level checks, and taking oral diabetes drugs, insulin, or both. Insulin therapy is essential for type 2 diabetes or gestational diabetes.
Insulins are sold in various types. There are short-acting (regular insulin), rapid-acting insulin, long-acting insulin, and intermediate options. What the patient needs depends on his condition, and the doctor may prescribe a combination of insulin types that can be used in the morning and night.
It’s important to know that insulin can’t be taken orally since stomach enzymes hinder insulin’s action. So, it is often injected using a fine needle, syringe, or an insulin pen. Otherwise, an insulin pump can be used instead of an insulin pen.
8. Conclusion
In a nutshell, you can get the answer to the question, “Is diabetes an auto-immune disease?”. You now know that diabetes is an auto-immune disease. Although there has been some dispute over this matter, it is suggested that both type 1 and type 2 diabetes are more closely linked than we think. They both may be considered auto-immune diseases, rather than the previous idea of type 2 diabetes being more of a metabolic disorder.
To learn more about which type of diabetes requires insulin, click here.
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