Despite the fact that millions of people have type-2 diabetes, the root cause of insulin resistance is not known

Now Stanford researchers say that type-2 diabetes is looking more and more like an autoimmune disease, rather than a strictly metabolic disorder.

The crux of their findings is that instead of creating antibodies against a foreign substance, immune system cells ‒ especially the B cells ‒ create antibodies against fat cells. Those antibodies then start attacking the fat cells, making them insulin resistant and hindering their ability to process fatty acids, which leads to the onset of type 2 diabetes.

If true, this will shift the emphasis in thinking of type 2 diabetes as a purely metabolic disease, and instead emphasize the role of the immune system in type 2.

The study’s findings will certainly change the way people think about obesity, and will likely impact medicine for years to come as physicians begin to switch their focus to immune-modulating treatments for type-2 diabetes.

Even the ADA’s chief scientific and medical officer David Kendall agrees. While ADA’s current approach to type 2 diabetes therapy won’t change, he says, it's important to understand that type 2 has multiple contributors to its onset. “For some people, it may be an immune component, and if it is, we should be able to develop some better therapies," he concedes.

People with type 2 diabetes are often blamed for bringing the disease on, but it's a combination of genetic and physiological factors exposed to a certain environment. And, this study points out what may be another important biologic factor.

This suggests the possibility of developing a vaccine for type 2 diabetes based on what appear to be protective antibodies in those who are obese but not insulin-resistant. That opens a whole new chapter in understanding type 2 diabetes.

See the full report here