Perspective Chapter: Immunosuppression in Patients with Diabetes Mellitus

Abstract

Diabetes is an age-dependent health issue prevalent worldwide and specially seen in those families with prevalent history of the disorder. Insufficient insulin production by the defective pancreas that leads to high blood glucose levels in the systemic circulation makes the patients more prone to an infection that exaggerates with time as compared to their counterparts. This increased prevalence of infections in diabetics may be due to defects in the immune functionality of the diabetes patients. High blood glucose level evokes inflammatory responses due to provoked inflammatory immune response against hyperglycemic condition in adipocytes and macrophages. The inflammatory mediators attack the pancreatic beta cells thus affecting the insulin production, which in-turn again results in hyperglycemia. Dysfunction of the immune response could not control the invasion of pathogens thereby, increasing the incidence of infectious diseases and related co- morbidities. This chapter discusses about immune dysfunction and suppression in T2DM and the underlying inflammation and infections in diabetics. An elaborate and in-depth understanding of the immune dysfunction in T2DM patients can help in the management and development of better targeted therapeutics to cure the disorder. It may also provide an insight in how to take care of one’s health as a precautionary measure to avoid the complications leading to diabetes and vice versa.

Varicella bullosa a rare form of chickenpox in an immunocompromised child: a case study

“…Numerous studies have revealed that people with diabetes are more likely to develop lower respiratory tract illnesses, such as pneumonia, urinary tract infections, pulmonary tuberculosis (TB), and infections of the skin and internal organ tissues. 11 Development of Otitis externa with conjunction of chickenpox in our patient may state that chickenpox can give rise to development of various complication as generally cause of otitis externa are bacterial infections as Pseudomonas aeruginosa and Staphylococcus aureus. 15 Antivirals should be administered as soon as possible to immunocompromised people and anyone who appears to be developing severe varicella for the best results.…”

“…It is essential for the development of cutting-edge therapies to treat infections in diabetic patients and enhance treatment outcomes to have a deeper understanding of the mechanisms of hyperglycemia that compromise host defence against pathogens. 11 There are evidence indicating that an immunocompromised state occurs only in the context of poor glycemic control with severe complications. 12 Low production of interleukins in response to infection and hyperglycaemia both increase some pathogens' virulence; decreased chemotaxis, decreased phagocytic activity, and immobilization of polymorphonuclear leukocytes.…”

“…12 Low production of interleukins in response to infection and hyperglycaemia both increase some pathogens' virulence; decreased chemotaxis, decreased phagocytic activity, and immobilization of polymorphonuclear leukocytes. 11 Unvaccinated children or there is no evidence of VZV immunity are at greater risk at developing severe varicella infection, of which some of the risk factors are immunosuppression, state of pregnancy, child with age >12 years, chronic skin or lung diseases, infancy. 13 A retrospective study conducted complications of varicella in unvaccinated children from Romania, 2002-2013 demonstrated younger patients (10.9 versus 13.8 years, p=0.001), male patients (56.5% versus 43.5% in females, p=0.001), patients diagnosed between 2007 and 2010 (33.7%, p=0.001), and patients diagnosed between 2011 and 2013 (46%, p=0.001) all had significantly higher rates of varicella complications including respiratory tract infections, followed by GIT and ENT complications.…”

Restraint Stress-Induced Immunosuppression Is Associated with Concurrent Macrophage Pyroptosis Cell Death in Mice

“…For example, studies conducted on diabetic animals revealed that insulin deficiency resulted in immunosuppressive effects, which were evident through the impairment of macrophage phagocytosis and cytokine production. These effects were subsequently restored upon administration of insulin [ 34 , 35 , 36 ]. In vivo depletion of macrophages using clodronate liposome treatments has been shown to suppress various experimental inflammatory diseases [ 37 , 38 , 39 , 40 ].…”