Diabetes + Inflammation: A Hot Couple!

Diabetes and Inflammation

Inflammation and the Immune System

Our immune system is like an internal army that consists of soldiers and weapons; when an invader such as a virus comes in, the immune system is activated and attacks. This battle can lead to inflammation. Our immune response is meant to protect our body and help it heal from an injury, infection, or other diseases. Still, too much inflammation (or inflammation that lasts too long) can damage our tissues and harm our health.

People with certain conditions like obesity (a BMI of 30 or greater) and uncontrolled diabetes with an elevated HbA1c level greater than or equal to 9.0% also often have chronic low-grade inflammation with some underlying immune system activations.

How Does This Happen?

For those with significant excess body weight, fat cells release another vital player (soldier) in the immune system called IL-6, which can trigger the release of C-reactive protein, or CRP. CRP is made mainly in the liver and increases in response to inflammation in the body. CRP can be anti-inflammatory by helping remove viruses and bacteria, or it can be pro-inflammatory by turning on other inflammatory systems in the body.

What Does It Mean If You Have Elevated CRP?

There have been correlations between elevated CRP and cardiovascular risk since it involves endothelial (lining of your blood vessels) dysfunction, resulting in artery-clogging plaque formation. However, high CRP is not always directly correlated with it affecting the heart. It doesn’t specify where the inflammation is coming from. Your doctor will order this test if there are risk factors for heart disease.

The CRP Test

CRP can be tested in a clinical setting through blood work, and can be used to see if the body is fighting an infection. It rapidly rises and drops once the condition improves. Normally you have low levels of CRP in your blood, so high levels may mean you have a condition causing inflammation. CRP has served as a marker in the hospital setting for severe COVID-19 patients, giving doctors early detection and guidance to treat these patients, decrease risk, and improve their outcomes.

When You Might Need a CRP Test

The CRP test can also be used as part of an advanced heart panel. However, the test results can be falsely lowered by certain medications, for example, non-steroidal anti-inflammatory drugs. Additionally, there is some controversy on whether or not it can be used as a direct measure of cardiovascular risk since it is not a specific test. Since the test is not specific to one condition, we should look at the patient’s entire history when using it. Then, it can serve as another tool and clinical guide.

CRP can be measured by your doctor if there are risk factors for cardiovascular diseases, such as smoking, being overweight or obese, uncontrolled diabetes, high cholesterol, and a sedentary lifestyle. If you have an elevated CRP, your doctor may recommend intensive medical treatment to decrease the risk.

Steps You Can Take to Reduce Inflammation

We have learned about inflammation, what causes it, and what it can do to our bodies, but how can we reduce low-grade inflammation? The answer is LIFESTYLE. This includes exercise, diet, quitting smoking, and good sleep (7-8 hours per night). Our bodies do so much for us, and a healthy lifestyle can help lower cardiovascular risk. In addition, eating foods high in fiber, such as leafy greens, and introducing good fats, as seen in nuts and fish (e.g., salmon), can help reduce inflammation. Going for a walk after dinner and intentionally walking are easy ways to stay active throughout the day. Finally, give your internal army the weapons to be fully equipped to fight for you when a true pathogen presents itself by living a healthy lifestyle.


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