From the Guidelines
A person with insulin-independent type 2 diabetes (T2D) is generally not considered immunocompromised, as supported by the guidelines from the Infectious Diseases Society of America 1. However, it's essential to note that diabetes mellitus, including type 2 diabetes, is listed among the chronic conditions that can lead to secondary deficiencies of the immune system, which may increase the risk of morbidity and mortality from various infections 1. The key factor influencing immune function in individuals with type 2 diabetes is the level of glycemic control. Poorly controlled diabetes can impair immune function by interfering with white blood cell activity and causing microvascular changes that reduce blood flow to tissues, making it harder for immune cells to reach infection sites. In contrast, well-controlled type 2 diabetes, typically managed through diet, exercise, and oral medications, allows the immune system to function at near-normal capacity. Therefore, individuals with insulin-independent type 2 diabetes should prioritize maintaining good glycemic control through appropriate medication adherence, regular monitoring of blood glucose, healthy eating habits, and regular physical activity to help preserve normal immune function and reduce infection risk. It's also crucial for healthcare providers to consider the individual's overall health status, including the presence of any other conditions that might affect immune function, when assessing their immunocompromised status and making recommendations for immunizations or other preventive measures, as outlined in the guidelines 1.
From the Research
Immunocompromised Status in Insulin-Independent Type 2 Diabetes
- A person with insulin-independent type 2 diabetes (T2D) may be considered immunocompromised due to the chronic inflammation and immune response associated with the disease 2.
- The immune system of individuals with T2D is affected by the high blood glucose levels, which can lead to dysfunction of the immune response and increased susceptibility to infections 2, 3.
- Studies have shown that patients with T2D have impaired immune responses, including reduced antibody production and impaired T-cell function 4, 3.
- However, it's worth noting that the immune system of individuals with T2D is not as severely impaired as those with type 1 diabetes, and the immune response can still be functional 4.
- The management of T2D, including the use of medications such as metformin and SGLT2 inhibitors, can also impact the immune system and increase the risk of certain infections 5, 6.
Factors Contributing to Immunocompromised Status
- Chronic inflammation and immune response associated with T2D 2
- High blood glucose levels leading to immune dysfunction 2, 3
- Impaired antibody production and T-cell function 4, 3
- Use of certain medications, such as metformin and SGLT2 inhibitors 5, 6
Increased Susceptibility to Infections
- Individuals with T2D are more susceptible to infections due to impaired immune responses 2, 3
- Certain infections, such as pneumonia and urinary tract infections, are more common in individuals with T2D 3
- The increased susceptibility to infections can be managed with proper treatment and prevention strategies, including vaccination and antibiotic therapy 4, 3