Inflammation and type 2 diabetes

A well-balanced inflammatory response maintains good health, prevents illness and aids recovery. However too much of an inflammatory response, known as a low-grade inflammatory response, is associated with a host of chronic diseases, one of which is type 2 diabetes. This article covers factors associated with inflammation that may increase risk for type 2 diabetes.

What is inflammation?

Inflammation is a local protective response to tissue injury. In response to this inflammatory process, the liver makes certain proteins, stimulated by substances called cytokines, which serve to limit the injury or assist with the healing process. However, when this response becomes ongoing and chronic, reflective of an unresolved crisis in the body, it is associated with many chronic diseases such as arthritis, cancers, heart disease and type 2 diabetes (1).

Low-grade inflammation and type 2 diabetes

Elevated circulating inflammatory markers predict the development of type 2 diabetes (2,3). Low-grade inflammation is associated with insulin resistance and impaired insulin secretion in type 2 diabetes. In comparison to healthy individuals, those with type 2 diabetes show significantly higher levels of inflammatory biomarkers. The reversal of type 2 diabetes results in significant reductions of levels of inflammatory biomarkers (4). Targeting inflammation is indicated to be effective for reducing the risk of developing type 2 diabetes, reversing it and reducing the severity of the disease, lowering blood sugar (glucose) levels (5).

Risk factors associated with inflammation and type 2 diabetes

Age

Aging is associated with a variety of changes in the immune system and increased inflammatory activity (6). Over 70s have increased levels of circulating proinflammatory biomarkers, independent of any disease (6).

Tip: focus on all of the factors that you can change, such as diet and exercise. An optimal diet and regular exercise reduce and delay age-related inflammation (7).

Inactivity

Low physical activity and inactivity is associated with increased levels of inflammatory biomarkers and a host of chronic diseases, one of which is type 2 diabetes (8). Just 20 minutes of exercise per day, like a brisk walk, decreases the inflammatory response and may protect against chronic conditions with low-grade inflammation (9).

Tip: introduce movement snacks! Start with introducing 2 x 5 min movement snacks a day. Set a reminder on your phone and then get to it. Choose one to be aerobic activity, like some star jumps, skipping, jogging and then choose the other to be body weight exercises, like some press ups, lunges, squats. You know what you’ve got on at 11am and 4pm!

Diet

A variety of dietary factors contribute to an inflammatory state. For example a reduced ratio of omega 3:6 fats, so not getting in enough oily fish but too many vegetable and corn oils, may become inflammatory (10). Highly processed foods, containing lots of refined sugars, trans-fats (that you find in store bought cookies, cakes, margarine), or that are heated at high temperatures, result in an inflammatory response (11). Also, continual snacking whilst being in an excess of energy can result in an inflammatory response (12).

Tip: replace any refined foods with whole foods and cook whenever possible. Include sources of flavonoids – choose blue, red and purple coloured fruits and vegetables, such as blueberries and raspberries. Eat more of the following: ginger, garlic and onions, dark leafy greens, salmon, avocado and apple cider vinegar. Keep cooking simple and make simple meals in under 30 mins. Examples include, eggs in any number of ways, pan friend/tray baked salmon or tofu with veg, vegetable curry.

Why not check out our anti-inflammatory recipe section for some meal ideas!

Smoking

Proinflammatory biomarkers are significantly higher in smokers and are positively increased with smoking intensity (13).

Tip: assess why you’re smoking and whether you can consider giving up for yourself. Access some support to help you on your way. If smoking is your de-stressor, check out Learn how to manage stress and chill out like a pro for some tips on how to manage stress! There are many ways to support smoking cessation now. One of our associate clinicians Jenny has helped people through the use of clinical hypnotherapy and associated techniques for stopping smoking.

Weight gain

As fat stores increase in size, they secrete harmful substances, which results in a proinflammatory response. Additionally visceral fat, fat stored around the organs at the abdomen area, particularly contribute to an inflammatory response. Therefore being overweight is associated with an inflammatory state and type 2 diabetes (14). Check out Insulin resistance and weight gain to learn more.

Tip: use diet and/or exercise to create a negative energy balance. Choose one simple achievable daily habit that you can begin today. Start off small and it will become easier as you gain a sense of accomplishment. Expect there to be challenges but commit to keep going regardless. Why not reach out and get some support with your weight loss and health journey.

Stress

Stress and inflammation are connected to one another and affect each other. Proinflammatory substances are secreted as a result of stress. Higher levels of stress are associated with excess weight, which is a proinflammatory state associated with type 2 diabetes – check out Stress and weight gain to learn more. Individuals with type 2 diabetes show higher levels of stress biomarkers, such as the stress hormone, cortisol and show elevated inflammatory biomarkers (15,5).

Tip: stress is complicated and affects all areas of life – emotional, work, financial, health etc. Assess your top 3 stressors in life and make a plan to improve the way you are responding to them. Ensure you are giving yourself daily opportunities to enjoy life. Check out Learn how to manage stress and chill out like a pro for some quality tips.

Sleep disturbance

Sleep disturbance is associated with higher levels of inflammatory biomarkers and females may be more vulnerable to sleep disturbance (16). Sleep disturbances are likely to be a stressor, therefore activating the stress response and an inflammatory response.

Tip: assess what is causing any sleep disturbances. If it’s worries, it’s likely that spending more time in the day processing what’s going on for you may help. Spending 5 mins journaling before you go to sleep is a great way to get some of the thoughts out of your head. Try it.

Insulin resistance

Insulin resistance is strongly associated with low-grade inflammation: proinflammatory biomarkers are significantly higher in individuals with insulin resistance (17). Proinflammatory substances induce insulin resistance (18). Once insulin resistance is present there is a viscous cycle between insulin resistance and inflammation, with them both exacerbating one another (19).

Tip: you can start becoming more insulin sensitive now by introducing more physical activity and exercise into your life – check out Improve insulin sensitivity with these exercise tips and 10 tips to Improve insulin sensitivity for some more!

Take away message

A balanced inflammatory response is vital for health: however, when this becomes ongoing, such as low-grade inflammation, it is associated with diseases like type 2 diabetes.

Lifestyle factors influence levels of inflammation: diet, physical activity, exercise, sleep, remaining stress free and a healthy weight, as well as not smoking contribute to optimising inflammatory levels.

Choose one factor to improve your inflammatory levels today: which lifestyle factor are you going to choose to improve today? Are you going to introduce some of those tasty foods and go for a run? Are you going to take a step towards giving up smoking or beginning the weight loss journey? Having support and accountability on our goals is proven to increase successful outcomes. Reach out to someone you can trust to support you on this journey.

If you enjoyed this article, you may also enjoy the following related articles:

• Learn how to manage stress and chill out like a pro
• Insulin resistance and weight gain
• Stress and weight gain
• Improve insulin sensitivity with these exercise tips
• 10 tips to improve insulin sensitivity

References

1. Furman et al. (2019). Chronic inflammation in the aetiology of disease across the life span.
2. Hu et al. (2004). Inflammatory markers and risk of developing type 2 diabetes in women.
3. Wang et al. (2013). Inflammatory markers and risk of type 2 diabetes. A systematic review and meta-analysis.
4. Athinarayanan et al. (2019). Long-term effects of a novel continuous remote care intervention including nutritional ketosis for the management of type 2 diabetes: a 2-year non-randomised clinical trial.
5. Donath et al. (2011). Type 2 diabetes as an inflammatory disease
6. Bruunsgard et al (2001). Aging and proinflammatory cytokines
7. Woods et al (2012). Exercise, inflammation and aging
8. Abramson et al. (2002). Relationship between physical activity and inflammation among apparently healthy middle-aged and older US adults.
9. Dimitrov et al. (2017). Inflammation and exercise: inhibition of monocytic intracellular TNF production by acute exercise via β2 –adrenergic activation
10. Innes et al. (2012). Omega-6 fatty acids and inflammation
11. Vlassara et al. (2002). Inflammatory mediators are reduced by dietary glycotoxins, a major risk factor for diabetic angiopathy.
12. Fung et al. (2016). Hyperinsulinemia and Insulin resistance: scope of the problem
13. Bakhru et al. (2005). Smoking cessation and cardiovascular disease risk factors: results from the third national health and nutrition examination survey.
14. Pickup et al. (2004). Inflammation and activated innate immunity in the pathogenesis of type 2 diabetes.
15. Chiodini et al. (2007). Cortisol secretion in patients with type 2 diabetes.
16. Irwin et al (2016). Sleep disturbance, sleep duration and inflammation: a systematic review and meta-analysis of cohort studies and experimental sleep deprivation.
17. Chen et al. (2004). Association between inflammation and insulin resistance in U.S Nondiabetic adults.
18. Kahn et al. (2006). Mechanisms linking obesity to insulin resistance and type 2 diabetes.
19. Rehman et al. (2016). Mechanisms of inflammatory responses and development of insulin resistance: how are they interlinked?