In diabetes and diabetic pain slow inflammation plays a key role. Recently Julie Lasselin and colleagues published an authorative article on slow inflammation and diabetes. They found slow inflammation to be explicitely important in patients suffering from diabetes and fatigue. And fatigue represents a common complaint of patients with diabetes: 60% of all diabetes patients suffer from fatigue.
Fatigue, diabetes and slow inflammation
In their article they clearly point out the relevance of slow inflammation in diabetes:
…several lines of evidence point to the possibility that inflammatory factors are involved. In support of this notion, recent data indicate that blockade of the inflammatory cyto- kine interleukin (IL)-1b with the monoclonal anti-IL1b antibody, XOMA052, partly improves motor fatigue in patients with type 2 diabetes. The ability of pro-inflammatory cytokines (e.g., IL-6, IL-1b, tumor necrosis factor (TNF)-a) to act on the brain and to induce behavioral symptoms, including fatigue, is well documented in both experimental and clinical studies…
Fatigue is not present in diabetic patients alone, neither is slow inflammation:
… the involvement of inflammation in the development of fatigue symptoms has been shown in patients with chronic medical conditions, including cancers, multiple sclerosis and chronic fatigue syndrome…
They point out the relevance of slow inflammation in many of these diseases:
…all of these conditions share in common the chronic activation of immune/inflammatory processes. Similar to these conditions, diabetes is characterized by a chronic, low- grade, inflammatory state….
And adipositas might be an extra factor contributing to this slow inflammation:
Adiposity is a distinguishing characteristic of type 2 diabetes that may easily promote the development of chronic inflammation, as adipocytes and infiltrated macrophages in the adipose tissue have the ability to secrete pro-inflammatory factors…
Slow inflammation and pathogenesis of diabetes
The authors also point out that slow inflammation is more than just a nuisance giving rise to fatigue. Slow inflammation might be one of the cornerstones of the pathology of diabetes:
Interestingly, systemic inflammation was found in many studies to be associated with an increased risk of developing type 2 diabetes, suggesting that inflammatory processes may also contribute to the pathophysiology of the disease..
In their study they found many data supporting their idea about this slow inflammatory process in diabetes and the stated:
Results from the present study indicate a higher prevalence of fatigue symptoms together with increased signs of systemic
Results from the present study indicate a higher prevalence of fatigue symptoms together with increased signs of systemic inflammation in patients with type 2 diabetes relatively to type 1 diabetic subjects. Consistent with our previous data fatigue symptoms in type 2 diabetic patients manifested primarily in the dimensions of general fatigue, physical fatigue and reduced activity. Interestingly, significant associations were found between fatigue symptom dimensions and circulating levels of inflammatory markers in type 2 diabetic patients, suggest- ing the involvement of inflammatory processes in the development of type 2 diabetes-related fatigue.
To our knowledge, this is the first time that such an association is shown in a diabetic population.
Slow inflammation and treatment via the anti-inflammatory natural compound palmitoyethanolamde
There are to date no widely know drugs to counteract slow inflammation but one, The molecule palmitoylethanolamide is a endogenous molecule which our cells synthesize in states of inflammation, this is called on demand synthesis. However, this synthesize is not sufficient and can be supported by adding external palmitoylethanolamide, as a supplement (PeaPure, een PEA-houdend product).
PeaPure for instance contains pure palmitoylethanolamide, without any chemical additives, and can be easily added to any medication scedule for diabetes.
In the Netherlands many hundreds of diabetic patients suffering from pain and fatigue have been succesfully treated with this supplement, without any side effects.
Palmitoylethanolamide modulates slow inflammation and has been explored in more than 300 scientific articles as a endogenous anti-inflammatory compound with extra analgesic properties. The recommended dose is 1200 mg /day, for instance two capsules 400 mg at breakfast and one during the evening meal.
Lasselin J, Layé S, Dexpert S, Aubert A, Gonzalez C, Gin H, Capuron L. Fatigue symptoms relate to systemic inflammation in patients with type 2 diabetes. Brain Behav Immun. 2012 Nov;26(8):1211-9. doi: 10.1016/j.bbi.2012.03.003. Epub 2012 Mar 25.