The pathogenesis and complications of type 2 diabetes (T2DM) are closely linked with defective glucose metabolism, obesity, cardiovascular disease and an inability to mount an effective immune response to certain pathogenic organisms. Perturbations in key innate immune receptors known as Toll-like receptors (TLRs) and inflammatory mediators such as IL-6, TNFα and IL-1β have been linked with T2DM. Herein, we sought to establish whether patients with T2DM and underlying complications exhibit perturbations in cytokine and TLR expression. Serum cytokine and mRNA levels of cytokines/TLRs in monocytes (M) and neutrophils (N) were measured in a cohort of 112 diabetic patients: good glycaemic control without complications (GC), good glycaemic control with complications (GCC), poor glycaemic control without complications (PC) and poor glycaemic control with complications (PCC) and compared them with 34 non-diabetic volunteers (NGT). Serum cytokine levels were normal in all study participants. In the GC group, cytokine and TLR gene expression were enhanced compared to NGT. In contrast, suppressed cytokine and TLR gene expression were evident in PC, GCC & PCC groups when compared to the GC. In conclusion, whereas serum pro-inflammatory cytokine levels are unaltered in T2DM patients, differences in inflammatory gene profiles exist among the T2DM patient groups.

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Objective: Pre-diabetes is defined as either impaired fasting glucose ((IFG) between 5.6 and 6.9mmol/l) or impaired glucose tolerance (IGT) wherein fasting or post-prandial plasma glucose levels are above normal levels, but below that of clinical Type-2-Diabetes Mellitus (T2DM). Both IFG and IGT, risk factors for T2DM and macrovascular diseases, have previously been linked with inflammation. With this in mind, we sought to comparatively evaluate the levels of inflammatory markers in pre-diabetics relative to normal healthy individuals. Methods:We determined the levels of serum cytokines in a cohort of 9 patients with pre-diabetes and thirty four individuals with normal glucose control using a 96-Well Multi-array 7-plex assay or 1-plex IFN-β and Rantes 96-well plates (Meso Scale Discovery, Gaithersburg, Maryland, USA). Results:Our study demonstrated that the patient group with pre-diabetes exhibited a non-significant trend towards elevated IL-6, TNFα, IFN-β, IL-12, Rantes, IL-10 and IL-8 when compared with the healthy controls group. After adjustment for age, sex, BMI and WHR, in the study population, there was no difference in the levels of cytokines between the pre-diabetes and normal groups. Conclusion:Measurement of serum cytokine levels alone is unlikely to be a predictor of clinical disease activity in individuals with prediabetes.