It's in the "inflammation" of blood vessels and the blood vessel walls that one part of the damage from diabetes is caused, and which then leads to complications caused by the damaged cardio-vascular system.
A few months ago it was reported in MedPageToday's medical news that British researchers had found that fitness had "an inverse association with total white blood cell count and white cell subfraction concentrations" whereas higher BMI (not good) had an positive correlation.
An elevated white-cell count is an independent predictor of coronary morbidity and mortality. The total white count comprises subfractions of neutrophils, lymphocytes, monocytes, basophils, and eosinophils, the authors noted.
In a model adjusted for age and BMI or MET, fitness and fatness maintained their associations with total white cell count. That that jargon means is that for example even taking into account that younger people might be more fit and older people more fat that amongst those groups fitness was always better and fatness always worse in terms of the risks being studied.
The authors suggested that the inverse association between fitness and neutrophils might be the key might explain the benefits of increased physical fitness with respect to atherosclerosis and cardiovascular disease.
It's thought that neutrophils may inflict endothelial damage by releasing free oxygen radicals and other cytotoxic substances, and that's where the potential connection to diabetes and the damage by diabetes to the blood vessel walls, and the increased risk of atherosclerosis, lies
There is a kind of similar "inflammation" which is caused by diabetes, although the exact causes are not fully know.
The main point is that fitness - as measured by this test - reduced the risk of cardio-vascular problems, and diabetes exacerbates those same problems, so by being fit and at the best BMI we as diabetics reduce our overall risk profile of likely cardio-vascular complications.
"It is reasonable to hypothesize that any mechanism that reduces the availability of neutrophils may retard the atherosclerotic process," the authors said. BMI also correlates directly with neutrophil concentrations, and weight loss has been shown to reduce levels of neutrophils and leukocytes, they added.
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