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Diabetes mellitus

  1. Jul 26, 2016 #1
    is it right to say that "diabetic patients are immunocompromised "? if yes then why?
     
  2. jcsd
  3. Jul 26, 2016 #2
    That is too general or broad. It also depends on the conditions patients are suffering from e.g complex glycemic control in their bodies due to an increase of ketone level or those with vascular abnormalities and peripheral neuropathy.
     
  4. Jul 26, 2016 #3
    Nope. DM is a metabolic disease characterized by a deficiency or dysfunction of insulin, hypoglycemic compound.

    Immunocompromised patients refers to the body's own immune system (AIDS, immunosuppressive therapy in transplant patients, etc).
     
  5. Jul 26, 2016 #4

    jim mcnamara

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    Staff: Mentor

    Diabetes mellitus is not a single disease.

    Type I diabetes involves the damaging of the Islets of Langerhans in the pancreas, such that insulin is either not produced at all or produced in limited quantities.
    Current thinking posits an autoimmune response that damages the pancreas. There is evidence of a genetic component. Usual patients are prepubertal, but adults can develop the condition. Characterized by high blood glucose levels, and higher than normal A1C hemoglobin results.

    Type II diabetes involves insulin resistance. The pancreas makes insulin, the receptor sites for insulin "get the message", cells do not respond so serum glucose levels remain high until the kidneys are able to reduce the level. Primary causes are environmental, largely a complex of dietary choices, total calories, low exercise levels, and obesity. It is believed there is a genetic component as well. Age of onset can be as low as 10 years of age. Very common in developed countries in older adults.

    Either type poorly controlled results in tissue damage: retina (diabetic retinopathy), neuropathy, kidneys, vascular system, skin. Basically it means that the diabetic has a lower life expectancy compared to non-diabetics. We do not need more details here really.

    So,answer: not immunocompromised unless you have a different, possibly non-standard definition.

    http://www.webmd.com/diabetes/type-1-diabetes-guide/default.htm
    http://www.webmd.com/diabetes/type-2-diabetes-guide/type-2-diabetes
     
  6. Jul 26, 2016 #5

    Fervent Freyja

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    Yes. Because, most diseases also fit into that category. Anything that is detrimental to the body enough to be called a disease compromises the function of the entire body over time, that also includes the immune system. Diseases should not be thought of as occurring in isolation from the rest of the system, it can affect the whole.
     
  7. Jul 27, 2016 #6

    jim mcnamara

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    I think we disagree. The immune system may be in "high gear" during many illnesses, and some of the pathology of diseases results from the immune system "overreacting". Immunocompromised:
    Example: HIV infections attacking the immune system.

    I would interpret impaired as as synonymous with 'turned off' or only working partially.

    Edit
    Prednisone is prescribed after eye surgery. Why? to prevent damage from post-surgical inflammation.
    Is this a compromised immune system? No.
    C-reactive protein (CRP) is known to be a mediator for coronary plaque buildup. CRP is part of inflammation, which is part of the immune system. Are Myocardial infarctions the the result of immunodeficiency or an impaired immune system? No.

    AFAIK type 1 diabetes is in the same category - except it is labelled autoimmune. Part of the pancreas in inflamed and badly damaged. Type 2 has less to with with the immune system and more to do with environmental factors.

    So I think behavior of the immune system when we perceive it to be overreacting are pathology, or at least totally unwanted, definitely. But not an impaired system at all.
     
    Last edited: Jul 27, 2016
  8. Jul 27, 2016 #7

    Fervent Freyja

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    How so? If all people have a perfectly operating immune system, then disease should never occur- the immune system protects us from getting a disease. Therefore, there is nothing wrong with defining *many* diseases as also having a compromised immune system.

    People with diabetes should be considered immunocompromised. It is well-known that patients with this disease should avoid cuts to the extremities, as there is a higher rate of infection and slower healing time for diabetic patients. Gangrene is also a threat. People with this should be aware that their immune system doesn't function like the average persons, a result of the disease limiting the circulation needed for healing, so that they take more precaution in preventing infections! Do you tell an elderly person with diabetes to not worry when the little cut on their foot is taking too long to heal or showing signs of gangrene- or do you caution them to keep an eye on it? Regardless of whether they qualify for the label of an autoimmune disorder or not, they should be aware that the disease indirectly compromises functions in other systems in the body, however slight it may be.
     
  9. Jul 27, 2016 #8

    Tom.G

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    It sounds like any 'disagreement' revolves around whether the immune system is part of the cause or part of the effect.
     
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