Perhaps the biggest remaining question is whether inflammation always precedes insulin resistance. “We don’t truly know which comes first,” says Aruna Pradhan, an epidemiologist at Brigham and Women’s Hospital in Boston. Insulin resistance could develop first and then incite inflammation through its effects on FOXO1. “It’s a chicken-and-egg question,” Dong says. “Nobody knows.”

And inflammation and insulin resistance aren’t the only factors to consider: genetics and environmental influences such as nutrition play a role in diabetes, too. In September 2009 Pradhan and her colleagues published a surprising study in the Journal of the American Medical Association showing that drugs that reduced insulin resistance had little effect on inflammation levels. Bizarrely, the subjects who received placebos had fewer signs of inflammation at the end of the study than those taking the drugs did, suggesting a complex interplay of factors. So even as scientists create a clearer picture of inflammation and diabetes, new puzzle pieces seem to keep adding more complexity to a complex disease.

Note: This article was originally printed with the title, "Inflammatory Clues."

8 Comments

1. 1. NTSRL 01:55 PM 12/15/09

   I read this article with a vested interest as a diabetic. I've developed a complication -- frozen shoulder -- which is described in internet articles as much more frequent among diabetics and thought to be some sort of auto-immune disease, in and of itself.

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2. 2. Karen Vaughan 03:37 PM 12/16/09

   For some time now I have considered insulin resistance, diabetes, depression (serotonin and other neurotransmitter resistance) and some kinds of infertility as different manifestations of cell membrane resistance, where the membranes don't let in nutrients. Often the membranes are "stiff" from a high Omega 6/ Omega 3 ratio and low mineral intake interferes with enzymes involved with cellular transport. So nutrients and their ferries, like the inflammatory insulin, stay in the blood, circulating and irritating the tissues. Diets high in sugar or other carbohydrates and allergenic foods increase the inflammatory conditions.

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3. 3. ihatesnow 06:06 PM 12/16/09

   if you have a computer you could help find a cure
   http://boinc.bakerlab.org/rosetta/

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4. 4. Quinn the Eskimo 01:28 PM 12/18/09

   If you *don't* have a computer--what are you doing here?
   
   I'm jus' sayin'

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5. 5. carbohydratescankill 09:44 AM 5/24/10

   Having reviewed articles in both medicine and nutrition, I found hyperglyucemia is inflammatory and pro-inflammatory, in addition to prothrombotic, hypertensive, and pro-glycation. Hyperglycemia is directly related to excessive consumption of carbohydrates. At first, beta cells were able to produce enough insulin to return the postprandial hyperglycemia to normal BG level, while they were attacked by the inflammation from hyperglycemia. They lose the cells more daily if excessive carbohydrate consumption continues. Eventually, the mass of beta cells is reduced to 40-60% of its original size and can no longer produce enough insulin for reducing the BG level to normal, thus diabetes mellitus is diagnosed.
   
   Yes, indeed, inflammation, a result of hyperglycemia from over-consumption of carbohydrates is the most important cause for the development of diseases including diabetes mellitus.
   
   Visit my blog at the website of my username for more information.

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6. 6. Ang 05:05 AM 8/25/10

   Does this in any way relate to the type of inflammation that copper spirales for contraception supposedly induce as well?

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7. 7. PrettyOld 10:37 AM 10/3/10

   Diabetes and Obesity is a direct result of food chemicals. The drug makers make 50 billions$$$ yearly of this disease! The FDA allows the drug makers chemicals in the food to do this and this has been scientifically proven.
   
   Diabetes drugs are criminal and destroy the heart muscle and still bring in 40 billion a year to the drug makers without a cure
   
   A filmmaker has been reversing diabetes in now 10 countries worldwide WITHOUT medications and the drug companies do not promote this
   
   just google SPIRIT HAPPY DIET
   

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8. 8. drreddick 07:18 PM 11/27/11

   If you would like a diabetes program that addresses insulin resistance AND inflammation, then, get the Death to Diabetes book. It was written by an engineer/biochemist who almost died from a diabetes coma.
   
   My wife was able to get off the insulin, lisinopril, and other drugs after 4 months on this program:
   http://www.deathtodiabetes.com/
   
   Here is the author on YouTube:
   http://www.youtube.com/watch?v=_ECUOu2rFto
   
   p.s. You don't have too buy his book -- his program is spelled out on his website.

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