THE IMMUNOINFLAMMATORY PROCESS IN TYPE 2 DIABETES MELLITUS. HOW CAN WE HELP?

Introduction: Type 2 diabetes mellitus (T2DM) is considered the epidemic of the 21st century, with more than 220 million sick people worldwide. It is calculated that this number will triplicate by 2030. It is present mainly in subjects over the age of 40, however, its association with obesity has increased its prevalence in younger subjects. The nutritional transition in which many countries are immersed, with a rapid change in family income, the adoption of inadequate lifestyles and very low levels of physical activity, have led to an increase in prevalence of diabetes. Its aetiology involves the immune system in a very important way. Obectives: To review the conditions in the immunoinflammatory process that lead to the development of T2DM and its complications, in search of ways to improve the condition. Development: T2DM is a pathology resulting from two main conditions in glucose metabolism, a decrease in the production of insulin or an increased resistance to it. Diabetes is closely related to an alteration of the innate immune system, with the production of pro-inflammatory cytokines and adipokines in a chronic way. Insulin resistance develops before the increase in some inflammatory markers such as C-reactive protein and plasminogen activator 1, among others. Tumor necrosis factor alfa, interleukins 1 alfa and beta, interleukin 6, interferon gamma, retinol binding protein and resistin are increased in type 2 diabetes mellitus. On the other hand, we can find decreases in adiponectin, leptin, ghrelin, visfatin and omentin production. The immunoinflammatory process is responsible for the complications such as retinopathy, nefropathy, neuropathy, cardiovascular and peripheral vascular diseases, as well as periodontal pathologies. There are several low-cost and widely available interventions that may be useful in decreasing or controlling the inflammatory process, such as supplementation with various vitamins, polyunsaturated fatty acids, etc. Conclusions: T2DM is a pathology, where cause and effect are related to the innate immune system, thus, by controlling this inflammatory process, we can avoid the consequent complications of the disease.