For decades, doctors and researchers believed that type 2 diabetes was a metabolic disorder. This type of disorder occurs when your body’s natural chemical processes don’t work properly.
Currently, there isn’t enough evidence to fully support this idea. For now, doctors will continue to prevent and treat type 2 diabetes with lifestyle changes, medications, and injected insulin.
Read on to learn more about the research that’s being done and the implications it may have on the treatment and prevention of type 2 diabetes.
Type 2 diabetes has historically been viewed as a different type of disease than type 1 diabetes, despite their similar names.
Type 1 diabetes
Type 1 diabetes is an autoimmune disease. It’s sometimes called juvenile diabetes because it’s often diagnosed in children and teens.
In people with type 1 diabetes, the immune system mistakenly attacks the healthy tissues of the body and destroys the insulin-producing cells of the pancreas. The damage from these attacks prevents the pancreas from supplying insulin to the body.
Type 2 diabetes
Type 2 diabetes occurs when your body becomes resistant to insulin or can’t produce enough insulin. The hormone insulin moves glucose from your blood to your cells. Your cells convert glucose to energy.
Early research suggests that the two types of diabetes may have more in common than previously believed. In the last decade, researchers have tested the idea that type 2 diabetes is an autoimmune disease, similar to type 1 diabetes.
Researchers have found evidence that insulin resistance may be the result of immune system cells attacking the body’s tissues. These cells are designed to produce the antibodies that fight invading bacteria, germs, and viruses.
In people with type 2 diabetes, these cells may mistakenly attack healthy tissue.
If type 2 diabetes is an autoimmune disease, the discovery may have big implications on our understanding of obesity. It’ll also affect the way obesity-induced type 2 diabetes is treated.
Doctors currently treat type 2 diabetes with two traditional approaches.
Doctors then typically prescribe oral medications that work in different ways to increase your body’s ability to use insulin, to make less glucose, and to perform other actions.
If medications don’t work, you may need to use insulin. Injections of insulin can help your cells absorb glucose and generate energy.
Some people with diabetes may be able to postpone insulin injections with healthy lifestyle changes and medications. Others may need them right away.
If type 2 diabetes is an autoimmune disease, that could change the treatment strategy. Instead of exercise and insulin, doctors might consider immunosuppressant medications.
One such immunosuppressant medicine is rituximab (Rituxan, MabThera). It belongs to a group of drugs known as anti-CD20 antibodies. These medicines are designed to target and eliminate the immunity cells that are attacking healthy tissue.
In one 2011 study, anti-CD20 antibodies successfully prevented lab mice at high risk for type 2 diabetes from developing the disorder. The treatment even restored their blood sugar levels to normal.
Some research indicates that medications affecting the immune system may benefit people with type 2 diabetes. Immunosuppressant medications such as anti-CD20 antibodies could prevent immune system cells, such as B cells, from attacking healthy tissue.
Currently, anti-CD20 antibodies are used to treat some autoimmune diseases, including rheumatoid arthritis (RA) and multiple sclerosis (MS). Using immunosuppressant medications to treat type 2 diabetes is a long way off, but the early results are promising.
The research suggesting that type 2 diabetes is an autoimmune disease represents a major advancement in medicine and in our understanding of the condition. Greater understanding of what might be causing type 2 diabetes is vital to providing the best and most effective treatments.
Future research could confirm that it is indeed an autoimmune disease. Then treatment and prevention will turn to novel therapies and medicines. This research opens the door to wider discussions about why and how diabetes develops — and what can be done to stop it.
More research is needed before type 2 diabetes is considered an autoimmune disease. Until that time, talk with your doctor about the future of this research. It’s good to have an ongoing conversation with them about the most recent diabetes research.
In the meantime, continue to test your blood sugar levels regularly, pump or inject insulin to maintain a “normal” range of blood sugar levels, and keep your body healthy.
It can also be helpful to connect with other people who understand what you’re going through. Our free app, T2D Healthline, connects you with real people living with type 2 diabetes. Ask questions, give advice, and build relationships with people who get it. Download the app for iPhone or Android.