Dietary Modulation of Chronic Inflammation of Diabetes: A Narrative Review

Abstract

Diabetes is a prevalent disease that affects millions of people around the world with severe and costly complications, such as neuropathy, retinopathy, nephropathy, peripheral vascular disease, ischemic heart disease, and cerebrovascular disease. It has been determined that prolonged state of hyperglycemia causes oxidative and nitrosamine stress and ischemia to the tissues, which leads to inflammation that the immune system cannot resolve. Because of this, diabetic patients live in a state of chronic inflammation. Current treatment of diabetes primarily revolves around glycemic control and lifestyle modifications; and while modern diabetic drugs continue to improve, nutritional aspects usually lag in the overall management of the disease. However, well optimized nutrition can not only minimize the source of inflammation and decrease the existing chronic inflammation, but it can also help the immune system to transition into the resolution and repair state. Such anti-inflammatory diet should abide by the following rules: 1) caloric restriction; 2) consumption of adequate amount of proteins; 3) decreased consumption of saturated fats; 4) increased consumption of unsaturated fats, especially omega-3 fatty acids; 5) increased intake of fermented fiber; 6) increased intake of polyphenols; 7) decreased consumption of both arachidonic acid and linoleic acid. It is important to mention that it might not be easy for the patient to switch their diet to the new one and maintain it over the long period of time. However, if done correctly, it might be a relatively cheap and effective addition to the standard medical treatment of diabetes.