Lupus is an immune disorder, a disease that causes the immune cells to attack healthy tissue. People don’t immediately connect lupus and diabetes; but the chances increase that a person will develop diabetes, when the person has lupus and a predisposition to problems with blood sugar.

Diabetes, in most cases, is more properly called “diabetes mellitus,” a condition wherein the body does not properly maintain insulin levels. When food or drink enters the body, it is broken into forms the body can use, including a type of simple sugar called glucose. Insulin is a hormone made in the pancreas; it controls the amount of glucose in the blood, and helps cells absorb it for fuel. If the pancreas doesn’t make enough insulin, the glucose levels in the blood rise too high, and a person experiences diabetes symptoms: increased urination, unexplained weight loss, and if allowed to progress, nerve and blood vessel damage, increased risk of heart attack, stroke and kidney failure. Sores and infections that don’t heal are also common, particularly in the legs and feet, and may become severe enough that amputation is necessary.

There are two types of diabetes: type 1, which destroys the cells that produce insulin and cannot be reversed and type 2, a resistance to insulin that most often develops as a result of overweight and obesity. 90% of diabetes cases are type 2, as obesity causes the body to demand more insulin than the pancreas can produce. Type 1 diabetes, however, is believed to be an immune disorder problem, similar in certain ways to lupus and perhaps connected to it, as well.
Unfortunately, diabetes and lupus share another type of connection: medications. Lupus is treated with corticosteroids, a drug form of the steroid “stress hormones” produced by the body, which cause the blood sugar levels to rise. Long-term use or high doses of corticosteroids, particularly Prednisone, can trigger diabetes in someone already predisposed to it.


Lupus And Diabetes: The Genetic Component


Type 2 diabetes is the body’s response to overweight and a poor diet – but type 1 results from an immune system attack. Type 1 diabetes and lupus both develop because of abnormalities in the B cells, a type of white blood cell responsible for identifying invading microorganisms, or “antigens,” such as viruses and bacteria.

The immune system itself is a delicate balance of cell reactions; increase and decrease, start and stop. Some cells trigger inflammation in response to infection or injury, a way of isolating the damage. Other cells recognize and destroy invaders, and yet another type halts this destructive process when it is no longer necessary. The cells primarily responsible for recognizing antigens and identifying them to other immune cells are the B cells, and the autoimmune reaction that causes both diabetes and lupus is due, in large part, to a faulty reaction that misidentifies healthy tissue as an invader.
B cells can initiate an immune system reaction to antigens of all kinds, which is why autoimmune diseases can have so many different forms and symptoms. A B-cell antibody that causes type 1 diabetes is not the same as an antibody that causes lupus. However, recent studies show that B-cells will stop producing both types of antibodies if the right proteins (called interleukin-10, or IL10, cytokines) are present in the bloodstream. Scientists are currently testing ways to stimulate production of these cytokine proteins in the body, or to introduce a synthetic form of IL10 that can do the same job.

People with lupus or diabetes – or both – can improve overall health and relieve a number of symptoms just by making healthy choices. A diet with fruits, vegetables, lean meats and dairy and whole grains is a good first step; adequate rest is also important. And exercise is crucial, both to control weight and insulin levels and to increase energy and improve mood. A healthy diet and a commitment to a treatment plan will strengthen the body and help the immune system return to a state of balance – and will make the treatment plan itself more effective.