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Is Type 2 Diabetes Is An Autoimmune Disease?

Researchers Say Type 2 Diabetes May Actually Be An Autoimmune Disease

Researchers Say Type 2 Diabetes May Actually Be An Autoimmune Disease

A new study from a group of Stanford University researchers suggests that, similar to type 1 diabetes, type 2 diabetes may be an autoimmune disorder. The classification of the disease as such could drastically change the way that doctors and scientists think about it, which may lead to the development of different treatments and medications. Type 1 diabetes is known as an autoimmune disorder because it has been shown that an individual's immune system attacks the insulin-producing cells of the pancreas, making it impossible for the organ to keep up with the body's demand for the blood sugar-controlling hormone. However, in type 2 diabetes, the body's tissue becomes resistant to the effects of insulin. While hypotheses have circulated as to the causes of this phenomenon, no scientist has been able to advance a complete theory to explain why tissue can become insulin resistant. The Stanford University researchers speculated that B cells, which are components of the immune system, target and attack the fatty tissue that surrounds the body's organs. This, in turn, leads to inflammation. When inflamed fat cells continue to expand, they die, and the immune system must continue to respond to the material left behind by dead fat cells. This process can take a toll on tissue. To test their theory, the researchers genetically engineered laboratory mice to lack B cells. The team reported in the journal Nature Medicine that when these animals were fed a high-fat diet, they became obese, but they did not show any signs of compromised metabolic function. "We are in the process of redefining one of the most common diseases in America as an autoimmune disease, rather than a purely metabolic disease," said Daniel Winer, MD, lead researcher of the Stanford University study, adding that t Continue reading >>

What Causes Autoimmune Diabetes?

What Causes Autoimmune Diabetes?

Autoimmune diabetes is influenced by genetics. What starts the autoimmune destruction is unknown, but it may be due to environmental factors. You may want to learn more about how type 1a diabetes develops. We know type 1a diabetes is caused by an autoimmune process in the body that mistakenly destroys the insulin-producing cells, or beta cells and occurs in genetically predisposed individuals. What starts the autoimmune destruction is unknown, but it may be due to environmental factors. In this section, you can learn more about: What is the Immune system? An overview of the different cells and organs in the immune system and how the immune system works Autoimmunity and diabetes: Current ideas about how the immune systems destroys insulin producing cells Continue reading >>

Are Obesity-related Insulin Resistance And Type 2 Diabetes Autoimmune Diseases?

Are Obesity-related Insulin Resistance And Type 2 Diabetes Autoimmune Diseases?

Obesity and associated insulin resistance predispose individuals to develop chronic metabolic diseases, such as type 2 diabetes and cardiovascular disease. Although these disorders affect a significant proportion of the global population, the underlying mechanisms of disease remain poorly understood. The discovery of elevated tumor necrosis factor-α in adipose tissue as an inducer of obesity-associated insulin resistance marked a new era of understanding that a subclinical inflammatory process underlies the insulin resistance and metabolic dysfunction that precedes type 2 diabetes. Advances in the field identified components of both the innate and adaptive immune response as key players in regulating such inflammatory processes. As antigen specificity is a hallmark of an adaptive immune response, its role in modulating the chronic inflammation that accompanies obesity and type 2 diabetes begs the question of whether insulin resistance and type 2 diabetes can have autoimmune components. In this Perspective, we summarize current data that pertain to the activation and perpetuation of adaptive immune responses during obesity and discuss key missing links and potential mechanisms for obesity-related insulin resistance and type 2 diabetes to be considered as potential autoimmune diseases. Traditional autoimmune diseases involve a wide spectrum of clinical pathology and include diseases such as systemic lupus erythematosus, multiple sclerosis, Sjögren’s syndrome, rheumatoid arthritis, and type 1 diabetes. A disease is considered autoimmune if its pathology is dictated by a self-antigen–specific adaptive immune response. Immunologists have adapted Koch’s postulates, originally conceived to establish a causative link between microbes and infectious diseases, to define k Continue reading >>

Type 2 Diabetes Mellitus--an Autoimmune Disease?

Type 2 Diabetes Mellitus--an Autoimmune Disease?

Abstract Inflammation-induced inhibition of the insulin signalling pathway can lead to insulin resistance and contribute to the development of type 2 diabetes mellitus (T2DM). Obesity and insulin resistance are associated with a chronic but subclinical inflammatory process that impairs insulin action in most tissues and could also hamper pancreatic β-cell function. The involvement of monocytic cells and the profiles of the chemokines and cytokines induced by this inflammation suggest an innate immune response. However, emerging data indicate that elements of the adaptive immune system could also be involved. As activation of an adaptive response requires antigen specificity, some researchers have hypothesized that T2DM evolves from an innate immune response to an autoimmune condition. In this Perspectives article, we present the arguments for and against this hypothesis and discuss which mechanisms could be involved in a putative switch from innate immunity to autoimmunity. Continue reading >>

Is Type 2 Diabetes Part Of The Autoimmune Diseases?

Is Type 2 Diabetes Part Of The Autoimmune Diseases?

INTRODUCTION Is type 2 diabetes an autoimmune disease? To answer this question, there is need for us to first know what the term ‘Autoimmunity‘ means. Autoimmunity is a highly complex, multi-factorial that is usually process defined by loss of self-tolerance and the reaction of B and T cells. It is excessively chronic, which also stem danger signals that are released when cells or tissues undergo abnormal cell death. Autoimmunity is a well-known pathogenic component in type 1 diabetes. The assumption that the pathogenesis of type 2 diabetes also encompasses autoimmune aspects is being increasingly recognized. WHAT IS AN AUTOIMMUNE DISEASE? Autoimmune disease refers to illness that occurs when the immune system of the body attacks and destroys cells there in. Autoimmune is a disease that I believe that many people with diabetes will have been familiar with by now. And we have always believed type 2 diabetes may be cause by the combination of genes. And even lifestyle because even experts have argued upon the importance of environmental factors , lifestyle, and gene in the development of Type 2 diabetes. Some studies however have connected diabetes to pollution and toxins. They have provided energy to the speculation that autoimmunity plays a role in the growth of type 2 diabetes. According to the US centres for disease control and Prevention. Close to 26 millions of people in America suffer from diabetes, not to talk of other people around the world. The most common cases of this diabetes are type 2 diabetes, which is about 90 to 95% of the entire population. In type 2 diabetes, the body does not either produce insulin or it ignores the presence of insulin in the body. The presence of insulin in the body is very important so that it can use glucose to produce energy. Continue reading >>

Is Type 2 Diabetes An Autoimmune Disease?

Is Type 2 Diabetes An Autoimmune Disease?

Type 2 diabetes is in the process of being redefined as an autoimmune disease rather than just a metabolic disorder, said an author of a new study published in Nature Medicine this week, the findings of which may lead to new diabetes treatments that target the immune system instead of trying to control blood sugar. As part of the study the researchers showed that an antibody called anti-CD20, which targets and eliminates mature B cells in the immune system, stopped diabetes type 2 developing in lab mice prone to develop the disease, and restored their blood sugar level to normal. Anti-CD20, available in the US under the trade names Rituxan and MabThera, is already approved as a treatment for some autoimmune diseases and blood cancers in humans, but more research is needed to see if it will work against diabetes in humans. The researchers believe that insulin resistance, the hallmark of type 2 diabetes (unlike type 1 diabetes where it is the insulin-producing cells that are destroyed), is the result of B cells and other immune cells attacking the body's own tissues. Co-first author Daniel Winer, now an endocrine pathologist at the University Health Network of the University of Toronto in Ontario, Canada, started working on the study as a postdoctoral scholar at Stanford University School of Medicine in California, USA. He told the press that: "We are in the process of redefining one of the most common diseases in America as an autoimmune disease, rather than a purely metabolic disease." "This work will change the way people think about obesity, and will likely impact medicine for years to come as physicians begin to switch their focus to immune-modulating treatments for type-2 diabetes," he added. The discovery brings type 2 diabetes, until now considered to be more of a Continue reading >>

Autoimmune Aspects Of Type 2 Diabetes Mellitus - A Mini-review

Autoimmune Aspects Of Type 2 Diabetes Mellitus - A Mini-review

Abstract Autoimmunity is a well-known pathogenic component in type 1 diabetes (T1DM). The assumption that the pathogenesis of type 2 diabetes (T2DM) also encompasses autoimmune aspects is recognized increasingly, based on the presence of circulating autoantibodies against β cells, self-reactive T cells, but also on the glucose-lowering efficacy of some immunomodulatory therapies in T2DM. The identification of these autoantibodies in elderly patients with slowly progressive manifestation of diabetes led to the introduction of a distinct clinical entity termed latent autoimmune diabetes of the adult (LADA), which combines features of both T1DM and T2DM. The autoantibody cluster differs in patients with LADA from patients with T1DM, but their presence indicates steady progression towards β-cell death and subsequent need for initiation of insulin treatment in a shorter period of time compared to autoantibody-negative T2DM patients. Autoimmune aspects in T2DM are not solely restricted to autoantibodies and thus LADA. They include the self-reactive T cells or defects in regulatory T cells (Tregs), which have been detected in autoantibody-negative T2DM patients as well. One contributor to the autoimmune activation in T2DM seems to be the chronic inflammatory state, characteristic of this disease. Upon inflammation-induced tissue destruction, cryptic ‘self' antigens can trigger an autoimmune response, which in turn accelerates β-cell death. Both innate and adaptive immune system components, specifically macrophages and self-reactive T cells, contribute to an increased secretion of inflammatory cytokines involved in inflammatory and autoimmune processes. However, the extent to which inflammation overlaps with autoimmunity is not known. Our review focuses on autoimmune invol Continue reading >>

Diabetes Overview

Diabetes Overview

Almost everyone knows someone who has diabetes. An estimated 23.6 million people in the United States -- 7.8 percent of the population -- have diabetes, a serious, lifelong condition. Of those, 17.9 million have been diagnosed, and about 5.7 million people have not yet been diagnosed. Each year, about 1.6 million people aged 20 or older are diagnosed with diabetes. Diabetes is a disorder of metabolism -- the way our bodies use digested food for growth and energy. Most of the food we eat is broken down into glucose, the form of sugar in the blood. Glucose is the main source of fuel for the body. After digestion, glucose passes into the bloodstream, where it is used by cells for growth and energy. For glucose to get into cells, insulin must be present. Insulin is a hormone produced by the pancreas, a large gland behind the stomach. When we eat, the pancreas automatically produces the right amount of insulin to move glucose from blood into our cells. In people with diabetes, however, the pancreas either produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced. Glucose builds up in the blood, overflows into the urine, and passes out of the body. Thus, the body loses its main source of fuel even though the blood contains large amounts of sugar. The three main types of diabetes are Type 1 Diabetes Type 1 diabetes is an autoimmune disease. An autoimmune disease results when the body's system for fighting infection (the immune system) turns against a part of the body. In diabetes, the immune system attacks the insulin-producing beta cells in the pancreas and destroys them. The pancreas then produces little or no insulin. A person who has type 1 diabetes must take insulin daily to live. At present, scientists do not know exactly wh Continue reading >>

Is Type 2 Diabetes An Autoimmune Disease?

Is Type 2 Diabetes An Autoimmune Disease?

Researchers in the Department of Laboratory Medicine and Pathobiology recently discovered an immune mechanism that links obesity with insulin resistance, a condition that raises the risk of heart disease and often leads to type 2 diabetes. The results, published last month by the journal Cell Reports, add to growing evidence that type 2 diabetes has an autoimmune component (in which the immune system attacks parts of healthy cells). The lead author on the study was Xavier Revelo, a postdoctoral fellow based at University Health Network in the lab of Professor Daniel Winer. Revelo spoke with Faculty of Medicine writer Jim Oldfield about his research and what it means for the understanding and treatment of insulin resistance and diabetes. What did you find in this study? We investigated the role of a mechanism that releases extracellular traps, which are structures composed of nucleic acids that immune cells use to prevent infection. We found that in obese mice, an excess release of nucleic-acid material promotes inflammation in visceral adipose tissue and the liver. That leads to insulin resistance and the buildup of glucose in the blood, which precedes the development of type 2 diabetes. We describe the different players that take part in nucleic acid-targeting pathways and show that blocking those pathways can prevent metabolic disease in our mouse model of obesity. Is type 2 diabetes an autoimmune disease? Well, right now there isn't enough evidence to include or dismiss type 2 diabetes as a classic autoimmune disease. However, this study and others have shown that obesity-related insulin resistance has several hallmarks that are typical of autoimmune diseases. For example, we found that diet-induced obesity led to an increased adaptive immune response against nucleic Continue reading >>

Is Type 2 Diabetes An Autoimmune Disease?

Is Type 2 Diabetes An Autoimmune Disease?

Insulin resistance is commonly observed in individuals with excess weight and has been considered a key mechanism underlying the rather strong association between obesity and increased risk for type 2 diabetes. However, the etiology of insulin resistance associated with weight gain or why this develops in some people and not in others remains unclear. As study by Daniel Winer and colleagues from the University of Toronto and Stanford University, just published in NATURE MEDICINE, now suggests a novel role of B-lymphocytes and autoantibodies in this relationship. B lymphocytes are immune cells that recognise antigens and ultimately lead to the production of anti-bodies. In this paper, the researchers show that B cells accumulate in the visceral fat of obese mice and that mice, lacking B cells appear protected against the development of insulin resistance with weight gain. The paper further shows that the B cell effects on glucose metabolism are mechanistically linked to the activation of proinflammatory macrophages and T cells and to the production of pathogenic IgG antibodies. Treatment of these insulin-resistant obese mice with a B cell-depleting CD20 antibody attenuates disease, whereas transfer of IgG from obese mice rapidly induces insulin resistance and glucose intolerance. Most importantly perhaps, the researchers also show that insulin resistance in obese humans is associated with a unique profile of IgG autoantibodies. Not only do these studies suggest a novel role for B cells and autoantibodies in the development of insulin resistance associated with weight gain, but if confirmed, these findings could lead to novel diagnostic tools (early detection of antibodies) and perhaps new treatments for type 2 diabetes (anti-CD20 antibodies are already used to treat some Continue reading >>

What Is An Autoimmune Disease?

What Is An Autoimmune Disease?

Tweet Autoimmune disease refers to illness or disorder that occurs when healthy tissue (cells) get destroyed by the body's own immune system. The term autoimmune disease is one that many people with diabetes - in particular, those with type 1 diabetes - will have come across or be familiar with. In the case of type 1 diabetes, the disease-fighting system mistakes healthy cells in the pancreas for foreign, harmful invaders and attacks them, leaving the body unable to produce its own insulin and keep levels of blood glucose under control. There are more than 80 different types of autoimmune disease, from multiple sclerosis and type 1 diabetes to coeliac disease and rheumatoid arthritis. The immune system is the body's protection against harmful substances such as bacteria, viruses and toxins, all of which contain harmful antigens. To counter this, the immune system produces and sends antibodies (special proteins) to identify destroy these antigens. However, in some cases the immune system cannot distinguish between healthy, harmless tissue and antigens and, as a result, it attacks and destroys normal tissue (in people with diabetes, the cells mistakenly targeted are the insulin-producing beta cells in the pancreas). This autoimmune reaction (or 'attack') is what triggers the development of an autoimmune disease. What causes the immune system to act this way? The exact cause of autoimmune disease is unknown, although there are many theories about what causes it to malfunction including: Bacteria or virus Drugs Chemical irritants Environmental irritants Studies have shown that autoimmune disorders often run in families and are much more common in women. How serious is it? As well as destroying body tissue, an autoimmune reaction can also affect organ function or result in t Continue reading >>

Are Obesity-related Insulin Resistance And Type 2 Diabetes Autoimmune Diseases?

Are Obesity-related Insulin Resistance And Type 2 Diabetes Autoimmune Diseases?

Abstract Obesity and associated insulin resistance predispose individuals to develop chronic metabolic diseases, such as type 2 diabetes and cardiovascular disease. Although these disorders affect a significant proportion of the global population, the underlying mechanisms of disease remain poorly understood. The discovery of elevated tumor necrosis factor-α in adipose tissue as an inducer of obesity-associated insulin resistance marked a new era of understanding that a subclinical inflammatory process underlies the insulin resistance and metabolic dysfunction that precedes type 2 diabetes. Advances in the field identified components of both the innate and adaptive immune response as key players in regulating such inflammatory processes. As antigen specificity is a hallmark of an adaptive immune response, its role in modulating the chronic inflammation that accompanies obesity and type 2 diabetes begs the question of whether insulin resistance and type 2 diabetes can have autoimmune components. In this Perspective, we summarize current data that pertain to the activation and perpetuation of adaptive immune responses during obesity and discuss key missing links and potential mechanisms for obesity-related insulin resistance and type 2 diabetes to be considered as potential autoimmune diseases. Continue reading >>

Type 2 Diabetes: Is It An Autoimmune Disease?

Type 2 Diabetes: Is It An Autoimmune Disease?

For decades, doctors and researchers have believed type 2 diabetes is a metabolic disorder. This type of disorder occurs when your body’s natural chemical processes don’t work properly. New research suggests type 2 diabetes may actually be an autoimmune disease. If that’s the case, new treatments and preventive measures may be developed to treat this condition. Currently, there isn’t enough evidence to fully support this idea. For now, doctors will continue to prevent and treat type 2 diabetes with diet, lifestyle changes, medications, and injected insulin. Read on to learn more about the research that’s being done and the implications it may have on the treatment and prevention of type 2 diabetes. Type 2 diabetes has historically been viewed as a different type of disease from type 1 diabetes, despite their similar name. Type 2 diabetes occurs when your body becomes resistant to insulin or can’t produce enough insulin. Insulin is a hormone that moves glucose from your blood to your cells. Your cells convert glucose to energy. Without insulin, your cells can’t use glucose, and symptoms of diabetes can occur. These symptoms may include fatigue, increased hunger, increased thirst, and blurred vision. Type 1 diabetes, sometimes called juvenile diabetes because it’s often diagnosed in children and teens, is an autoimmune disease. In people with type 1 diabetes, the immune system mistakenly attacks the healthy tissues of the body and destroys the insulin-producing cells of the pancreas. The damage from these attacks prevents the pancreas from supplying insulin to the body. Without an adequate supply of insulin, cells can’t get the energy they need. Blood sugar levels rise, leading to symptoms such as frequent urination, increased thirst, and irritability. E Continue reading >>

Type-2 Diabetes An Autoimmune Disease?

Type-2 Diabetes An Autoimmune Disease?

Stanford researchers, led by pathologist Edgar Engleman , MD, reported today in Nature Medicine that type-2 diabetes is looking more and more like an autoimmune disease, rather than a strictly metabolic disorder. According to co-first author Daniel Winer, MD: This work will change the way people think about obesity, and will likely impact medicine for years to come as physicians begin to switch their focus to immune-modulating treatments for type-2 diabetes. Winer shares co-first authorship with his twin brother, Shawn Winer, MD, PhD, and research associate Lei Shen, MD, PhD, (pictured here, right, with Engleman, left). Daniel Winer was a post-doctoral fellow in Engleman's lab when the research was conducted; both Winer brothers are now at the University of Toronto. Type-2 diabetes is characterized by the gradual development of insulin resistance, which affects the ability of the body to properly metabolize glucose. It's associated with being overweight, but it can also have a genetic component. Despite the fact that millions of people have type-2 diabetes, the root cause of the insulin resistance is not known. In 2009, Daniel and Shawn Winer showed (also in Nature Medicine; subscription required) that T cells of the immune system were involved. Now they found that another immune cell, called a B cell, also plays an important role. The researchers found that mice genetically engineered to lack B cells were protected from developing insulin resistance even when they grew obese on the high-fat diet. However, injecting these mice with B cells or purified antibodies from obese, insulin-resistant mice significantly impaired their ability to metabolize glucose and caused their fasting insulin levels to increase. Interestingly, treating the mice with a compound called anti-CD Continue reading >>

Is Type 2 Diabetes A Chronic Inflammatory/autoimmune Disease?

Is Type 2 Diabetes A Chronic Inflammatory/autoimmune Disease?

Abstract The classification of diabetes mellitus into 2 main types, defined as Type 1 and 2 diabetes (T1DM, T2DM) relies mostly on the requirement of insulin therapy and on the presence of detectable immunologic abnormalities. However, this distinction is far from straightforward and there is considerable overlap between these 2 types of diabetes. Islet cell autoimmunity, which is characteristic of T1DM, appears in fact to be present in up to 10-15% of subjects diagnosed clinically with T2DM. In the UK Prospective Diabetes Study (UKPDS), it was reported that in patients diagnosed with in T2DM, the presence of autoantibodies to the enzyme glutamic acid decarboxylase (GAD) and cytoplasmic islet cell antibodies (ICA) were a predictor of insulin requirement as compared with patients not carrying these autoantibodies. These results are strikingly similar to a number of prospective studies carried out in childhood diabetes. If islet cell autoimmunity is truly present in 10-15% of subjects clinically diagnosed with T2DM, up to two million Americans might have an unidentified autoimmune form of T2DM, a prevalence similar to that of recent onset childhood diabetes. In addition, we found that in a subset of T2DM patients, a pronounced activation of the acute phase response that seems to be associated with islet cell autoimmunity. These results may in part explain the defect in insulin secretion as well as insulin resistance seen in T2DM. The identification of a subgroup of individuals at risk of developing T2DM using autoantibody as well as inflammatory markers is of public health interest, not only for the correct classification of diabetes, but also because immunomodulatory therapeutic strategies could potentially be instituted sufficiently early in a large number of patients d Continue reading >>

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