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Could snacking between meals drive an inflammatory response in diabetes?

Comment by Paul Leeson, EACPR Exercise, Basic and Translational Research Section

Diabetes and the Heart

Recent studies by a research group in Warwick, UK have explored whether dietary patterns in diabetics might drive a persistent inflammatory response relevant to the development of vascular disease.
A paper by Harte et al. looked at factors that are released into the circulation following a high fat meal. They were particularly interested in ‘endotoxin’, the lipopolysaccharide outer cell membrane of gram-negative gut bacteria, which is released from the gut into the portal circulation and can then be identified in the systemic circulation. The substance has been known about for over 30 years and is thought to induce an innate immune inflammatory response particularly in adipose tissue.

In the current paper they looked at circulating levels following a high fat meal in those with Type 2 diabetes, impaired glucose tolerance and normals. They found higher levels in all subjects by one hour after the meal but substantially greater rises in those with Type 2 diabetes up to 4 hours later. They argue that repeated small meals may therefore lead to chronic elevation of endotoxin levels in those with Type 2 diabetes and a subsequent chronic inflammatory state.

This is one of several possible mechanisms linking dietary patterns in Type 2 diabetes with subsequent cardiovascular risks and further experimental studies will be of interest to understand fully its importance as a disease mechanism.