Does Diabetes make you Immunocompromised?

An immunocompromised state is a condition where the immune system of the body becomes inefficient in fighting infections. This can lead to having frequent infections. It is a well-known fact that HIV AIDS is the ultimate immunocompromised state. But the reason you are probably here is that somewhere you might have read or heard that diabetes makes you immunocompromised, but is it true? We will go briefly through what diabetes is and then find out whether diabetes makes you immunocompromised. If yes then how so.

What is Diabetes or Diabetes Mellitus?

Diabetes is a condition where the blood sugar level of the body stays chronically high. It is associated with insulin dysfunction. Insulin is a hormone made by the pancreas that tells the cells of the body to use up sugar in the blood as fuel. If insulin is deficient (as in Type I Diabetes) or insulin can’t communicate properly with the cells to burn the sugar for energy (it is called Insulin Resistance, and seen in Type 2 Diabetes), the blood sugar starts remaining high all the time. And if the blood sugar remains high for a long time, it potentially becomes toxic to the body and can virtually damage all the organs in the body and thus multiple health consequences.

Can Diabetes make you Immunocompromised?

Like any other organ system, Diabetes can affect the immune system as well, dampening its strength to fight infection, as such diabetics often become the victim of frequent infection. So we can say that diabetes can make you immunocompromised, ONLY IF the blood sugar level doesn’t remain in control for a long time. How does diabetes affect the immune system? Well, there are multiple hypotheses; uncontrolled diabetes can affect different cells of the immune system in the following ways:

• Macrophage Dysfunction: Macrophages are cells of the immune system and are known to eat up microorganisms, a process known as phagocytosis. Diabetes has been found to impair the process of phagocytosis.
• Neutrophil Dysfunction: Neutrophils are another group of cells of the immune system that are known to kill organisms by producing something which is known as Reactive Oxygen Species (ROS). However, patients with uncontrolled diabetes were found to have reduced production of ROS.
• Natural Killer Cell Dysfunction: These born to kill cells of the immune system have some special chemicals which they can release on invading microorganisms, but only when they are activated. Diabetics were found to have reduced capability of activating such cells.
• Inability to Identify Microorganisms: Immune Cells don’t have eyes to identify microorganisms. But instead what they have something special known as Toll-like Receptors (TLR) on its surface which they use to identify pathogens when they get in touch with them. Diabetics often have decreased TLR on their immune cells; as such they often fail to identify invading pathogens.
• Leukocyte Recruitment Defects: Leukocyte is another type of immune cell that fights infection. But in diabetics, there is often a failure to recruit those cells, and they just roam in the blood without a purpose.
• Defective Antibodies: Antibodies are the product of B-Cells of the immune system. One way of neutralizing a threat is that Antibodies coat the surface of microorganisms and activate a complex immune process called the Complement Pathway to cause damage to the cell wall of the invading pathogen and thus causing it to die. However, in diabetics antibodies fail to activate the complement pathway, leading to the progress of infection.

Now that you know that diabetes can make you immunocompromised, but only if it has been out of control for a long time; so, if you make sure your blood sugar stays in control, you would not have to worry much about your immune system.