Uncontrolled diabetes, with an average blood glucose of more than 200 mg/dL, suppresses the immune system, say experts. Diabetes can thus impair the immunity, increasing the risk of infections.
People with high glucose levels can develop inflammation in the body, which works against the immune system. Low immunity can reduce the effectiveness of the white blood cells. Dr Mahesh D M, consultant – endocrinology, Aster CMI Hospital, says, “The cytokine (small proteins that help control inflammation) production gets affected, causing defects in the function of the white blood cells which is to kill the bacteria.”
How does diabetes affect the immune system?
Hyperglycemia or uncontrolled diabetes can also lead to an increase of Tumour Necrosis Factor alpha (TNF alpha, an inflammatory cytokine) in the body that affects the immune system. “This also causes an increase in free fatty acids (fat molecules released from adipose tissue), which reduce the immune system’s effect of protection against infection,” he adds.
The most common complications in people with diabetes due to low immunity are respiratory (like pneumonia) and urinary tract infections. Fungal infections like genital candidiasis and tuberculosis, especially in developing countries like India, are also common among people with diabetes due to high blood sugar, say experts. Due to recurrent infections and subsequent inflammation, there is an indirect risk for atherosclerosis as well.
Does diabetes weaken the immune system?
Insulin can help regulate sugar levels and hence, plays an important role in immune health. Dr. Satyam Chakraborty, consultant endocrinology, Fortis Hospital, Kolkata, adds, “If there is less insulin or if insulin is ineffective, there will be hyperglycemia. There will be a glycemic burden in the entire body and on the immune cells. This will blunt the immune response towards a foreign protein, be it virus, bacteria or protozoa.”
The immune system works with T cells (destroys infected cells) and B cells (produces antibodies). “The T cells attack the organism by releasing a few chemicals. But if these T cells are loaded with glucose inside them, they become incompetent to release the required chemicals or they release in an abrupt and inconsistent manner,” he explains.
Why is COVID worse in diabetics?
Citing the link between diabetes and COVID-19 pandemic , he adds the mortality was high because of the bizarre immune response, which was due to the underlying uncontrolled hyperglycemia. “The immune system behaved in an absurd way where it destroyed the body’s own proteins. This indirectly signifies that uncontrolled hyperglycemia has a role in modulating the immune system,” he adds.
Dr Mahesh says, “When one with uncontrolled sugar gets an infection, they usually are hospitalized for a longer time. The recovery time is also almost 1.5 to 2 times more than others with normal blood glucose levels. The outcome can be poor and the economic burden high because of the cost of care and length of treatment.”
How to boost immunity, if diabetic
However, if the sugar is brought under control, the immune response also improves. He says if HbA1c is less than 6.5 or 7, the immune system will function much better. The infections and wounds will heal better, and the risk of complications will also be less.
But it is important to keep sugar levels under control for a prolonged period. Dr Chakraborty says, many might go back to a poor lifestyle once the sugar levels come under control and then try to maintain it only if they develop any health complications again. “The fluctuations in sugar levels, which is referred to as glycemic variability, can affect the immune system more. No supplements can help boost immunity if the blood sugar is not under control,” he says.
Experts suggest the following ways to improve immunity:
- Maintain normal blood glucose levels
- Frequently monitor sugar levels
- Take medicines on time
- Maintain healthy lifestyle
- Regular workouts
- Take more antioxidants in the form of fruits and vegetables
- Adequate protein intake is required
- Include these six foods in your diet to boost your immunity
Takeaways
- Uncontrolled sugar can affect the immune system, weakening it to fight against infections.
- It compromises the immune system by causing inflammation and affecting the functions of white blood cells.
- It can lead to respiratory and urinary tract infections and tuberculosis, particularly in developing countries like India.
- People with diabetes and immune deficiency take longer recovery time, causing poor outcomes and high cost.
- However, maintaining sugar levels under control for prolonged periods can improve immune function.
- Controlling sugar levels by regular follow-ups and a healthy lifestyle can help boost the immune system.
