Targeting Inflammation to Improve Prediabetes and Type 2 Diabetes Outcomes

Diabetes is a significant health concern in the United States, affecting a staggering 34 million adults, with an additional 88 million individuals having prediabetes. Unfortunately, the prevalence of diabetes continues to rise, and current prevention efforts have been unsuccessful in reversing this troubling trend (Centers for Disease Control and Prevention, 2017; U.S. Department of Health and Human Services, 2020). Consequently, further research is necessary to develop effective strategies for preventing and treating this chronic and highly prevalent disease.

Diet and lifestyle programs designed specifically for individuals with prediabetes have shown promise in preventing or delaying the progression to type 2 diabetes (T2DM) (Knowler et al., 2002). The Diabetes Prevention Program, a three-arm randomized controlled trial, demonstrated that intensive lifestyle modifications aimed at achieving a 7% reduction in body weight can indeed prevent or delay the onset of diabetes (Knowler et al., 2002).

T2DM is characterized as a chronic progressive disease resulting from insulin resistance, which leads to the gradual dysfunction of beta cells and a subsequent decline in endogenous insulin production (Fonseca, 2009). This decline renders the body incapable of compensating for sustained hyperglycemia and the insulin-resistant state (Fonseca, 2009). Current treatment guidelines for T2DM primarily focus on glycemic control (American Diabetes Association, 2020). The American Diabetes Association (ADA) recommends achieving an HbA1c level below 7% (American Diabetes Association, 2020), while the American Association of Clinical Endocrinologists (AACE) similarly suggests targeting an HbA1c level below 6.5% (Garber et al., 2020).

Diabetes also carries an increased risk of various long-term complications, including heart disease, stroke, nephropathy, retinopathy, and neuropathy. Unfortunately, current treatment efforts fail to adequately prevent these complications. For instance, the prevalence of kidney disease in adults aged 18 years and older was 37% during the period of 2013-2016 (U.S. Department of Health and Human Services, 2020). Additionally, diabetes ranked as the seventh leading cause of death in 2017 (U.S. Department of Health and Human Services, 2020). Therefore, identifying alternative treatment strategies that can help halt or reverse the progression of diabetes may significantly improve the quality of life and reduce mortality rates for individuals diagnosed with this disease.