Diabetes: A by-product of chronic low-grade inflammation (SQ-124)

According to a WHO fact sheet, an estimated 1.5 million deaths were directly caused by diabetes in 2012 and the disease will be the 7th leading cause of death in 2030.

With a range of complications it can potentially lead to – including the risk of kidney failure, cardiovascular disease, nerve damage, circulatory disorders, vison problems and gum infection – diabetes is more dangerous than what you imagine. But the good news is you can prevent, manage and may even reverse diabetes by fixing the underlying risk factors. Researchers in the field believe that adopting correct nutritional strategies, relying on nutrient rich diets, losing weight and exercising daily can help address the triggers while reversing abnormal glucose level fluctuations in blood.

Insulin and blood glucose levels

In people diagnosed with Type 2 diabetes, pancreatic islets fail to produce sufficient insulin and/or the body stops responding to insulin, a condition known as insulin resistance. In type 1 diabetes, the body is not able to make insulin as the immune system has attacked and destroyed the beta cells.

Glucose, from the food we eat, enters the bloodstream to be absorbed by cells. Our cells constantly need glucose to produce energy in order to kick-start and maintain a range of complex bio-chemical reactions within the body, keeping us healthy and alive. However, our cells are absolutely incapable of utilizing the available glucose without insulin – a hormone secreted by the beta cells of the pancreas. Insulin facilitates the entry of glucose into muscle cells, red blood cells, adipose and other tissues. Simply put, one of the major roles that insulin play is to help reduce glucose levels in the blood. (Yes, insulin has other important functions too, such as being a part of mechanism that relaxes/dilates blood vessels.)

Inflammation and Diabetes

There are many factors that can trigger diabetes such as your genetic make-up, family history, lifestyle and environmental factors. Lately, researchers have clearly established the role of inflammation in the pathogenesis of type 2 diabetes. A number of clinical studies and research data suggest that chronic low-grade inflammation may be one of most important underlying mechanism that triggers the onset of Type 2 diabetes. And it turns out that inflammation is both the root cause and the result of diabetes, creating a vicious circle that further complicates the matter. In fact, the debate on what comes first “diabetes or inflammation?” is a hot topic yet open to speculation by scientists and researchers. A case of chicken and egg?

While short-term inflammation is an important mechanism that fights pathogens and heals the body, prolonged and chronic inflammation keeps the immune system fired up all the time, continuously activating and sending immune cells such as lymphocytes and macrophages to the site of inflammation. This onslaught of immune cells results in the secretion of pro-inflammatory cytokines such as IL-1β, IFN-γ, TNF-α, and CRP. And increase in these circulating cytokines leads to the failure of β-cell function and β-cell mass reduction – a hallmark of diabetes.

Inflammation is an explosive mix of many factors such as genetics, environmental factors like smoking, exposure to radiation, toxic metals, unhealthy lifestyle, over-dependence on processed foods, mental stress, obesity and others. All of these factors encourage free radical formation. The result? Increased systemic oxidative stress and resulting inflammation that stays.

A 2009 study published in the Journal of Clinical Endocrinology and Metabolism indicates that activation of inflammatory pathways and endothelial dysfunction are some of the major mechanisms causing beta-cell damage, insulin resistance, and the vascular complications associated with diabetes.  As concluded by the authors, “Increased CRP, IL-6, and TNFalpha, and especially interstitial cellular adhesion molecule-1, vascular cellular adhesion molecule-1, and E-selectin are associated with nephropathy, retinopathy, and cardiovascular disease in both type 1 and type 2 diabetes.”

A 2013 meta-analysis published in Diabetes Care also provides substantial evidence that elevated levels of inflammation biomarkers (IL-6 and CRP) are significantly associated with increased risk of type 2 diabetes.

While inflammation sets the stage for prediabetes and type 2 diabetes, resulting impairment in beta cells functions leads to increased insulin resistance and higher concentrations of glucose in the blood. Excessive glucose circulating in the blood inflicts much damage to tissues and vital organs. These extra sugar molecules attach or bind to the proteins, altering their structure and functions, and form corrupt protein molecules (known as Advanced Glycation End Products or AGEs). AGEs molecules block nitric oxide activity in the endothelium (lining of the blood vessels) and generate reactive oxygen species that damage the fragile cellular structures, tissues and organs.

That’s one of the mechanisms by which consistently high blood glucose levels contribute to large blood vessel damage causing stroke and heart disease while also damaging small blood vessels found in nerves, kidneys and eyes. No wonder that diabetes is a leading cause of cardiovascular diseases, micro-circulation problems, diabetic retinopathy - which can lead to blindness - kidney failure and neuropathy leading to lower limb amputations.

The good news? Role of Vitamin C in Type 2 Diabetes

Vitamin C has been known to lower glucose levels in the blood while also potentially reducing the severity and occurrence of the associated complications. Why does it make so much sense? Vitamin C is a super anti-oxidant that helps the body to counter the effects of free radicals known to cause chronic inflammation in the body. Drawing on its powerful anti-oxidant capacity, Vitamin C can help reduce the inflammation markers such as C-reactive protein and other cytokines.   

A 2015 report published in Avicenna Journal of Phytomedicine suggests that it is very much possible to control insulin resistance and diabetes by modulating inflammatory cytokines and other chemicals using micronutrients supplementation. The authors concluded that “consumption of supplementary vitamins C and E could decrease induced inflammatory response in patients with diabetes mellitus type 2. It is also possible that vitamin C and vitamin E supplementation can attenuate incidence of some proposed pathological effects of diabetes mellitus.”

Another study published in 2015 studied the role of vitamin C as an anti-inflammatory agent and its effects in reducing the levels of inflammatory markers in obese adults with high blood pressure and/or diabetes. And given the anti-oxidant capacity of Vitamin C, the result were hardly surprising, “Vitamin C (500 mg twice daily) has potential effects in alleviating inflammatory status by reducing hs-CRP, IL-6, and FBG in hypertensive and/or diabetic obese patients.”

Another interesting mechanism where Vitamin C can be linked with diabetes prevention is through leptin inhibition. A 2010 study published in Journal of Molecular Endocrinology shows that Vitamin C inhibits leptin secretion and glucose uptake. Increased leptin, a hormone that is produced by the body’s fat cells and regulates appetite and weight, is associated with increased risk of developing diabetes.  

Another important study indicates that daily consumption of 1,000 mg of supplementary vitamin C may bring down the levels of lipids and blood glucose in type 2 diabetics and as such reducing the risk of underlying complications associated with diabetes.  

We are in no way suggesting that supplements can override the benefits of wholesome, balanced diet. At the same time, most studies indicate that we need to consume Vitamin C in much higher doses in order to achieve the real benefits. Experts believe that we may need Vitamin C in doses that is 10 times greater than the recommended daily allowance. That’s why trying to achieve desired results with typical Vitamin C supplements may result in disappointment. It is because only a small fraction of Vitamin C in conventional tablet or capsule products reaches the bloodstream after absorption and even lesser amount is able to cross the cell-membrane barrier.

Liposomal technology, however, is a very effective strategy to supplement your body with this important nutrient that our body is incapable of making itself.  Liposomal Vitamin C facilitates the delivery of this important nutrient to the target cells much more efficiently. Liposomal Vitamin C with added glutathione, another master anti-oxidant, is even better if you can get the two in a combined product. Not only does glutathione adds to the anti-oxidant force of Vitamin C, it also recycles used Vitamin C and Vitamin E.

An important note:  Besides autoimmunity and inflammation, there are other factors at play that results in the reduction of beta cell functions as well as their numbers, for example high glucose concentrations, lipoprotein profiles, adipokines, amyloid deposits in the pancreatic islets and insulin resistance. We have limited the scope of this article to explore the effect of low grade systemic inflammation on the beta cells and how Vitamin C can address the underlying risk factors.

Disclaimer

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