21 June 22 Article 01

The Bitter Sweet Truth about Diabetes and Immunity

A healthy immune system is vital to protect our body from infections.  It has many types of organs and cells specialised in fighting germs.  However, for people with diabetes, this system is compromised and thus, causing them to fall sick easily.


How does diabetes affect the immune system

Poor blood sugar control can affect white blood cells activity  and delay the time taken for the cells to react to any virus or bacteria invasion. (1,2) This also affects the cells ability to fight and kill pathogens, and thus, allowing more viruses or bacteria to reproduce and infect the body. (1,2) Besides that, high blood sugar also inhibits the production of antibodies that are essential to kill germs. (1)


What can people with diabetes do

It is important for people with diabetes to maintain healthy blood sugar levels as high levels can impair immune response and cause reduced immunity.  Here are some of the ways to help you manage diabetes and prevent blood sugar spikes (3-5):


  1. Choose healthier sources of carbohydrates

Healthier sources of carbohydrates such as brown rice, whole grain bread, whole grain noodles, potatoes, corn, and pumpkin, are also good sources of fibre, which can help prevent blood sugar spikes.


  1. Control your food portion

Portion control is important to maintain a good blood sugar control, especially carbohydrate food sources. Follow the Malaysian Healthy Plate Method for better portion control:



Source: Kementerian Kesihatan Malaysia

  • Fill 1/2 of your plate with fruits and vegetables
  • 1/4 of your plate withhealthy carbohydrate sources such as brown rice, whole grain bread, potatoes, and corn
  • The remaining 1/4 with healthy protein sources such as lean meat, eggs, legumes or tofu


  1. Eat on time

Eating on time is as important as eating healthy meals. Skipping meals or not eating on time causes your body to release even more glucose into the bloodstream to produce energy. Besides that, it can also lead to overeating later on, causing blood sugar spikes and fluctuation.


  1. Speak to your friendly dietitian. Your dietitian can help you  plan and set nutrition goals according to your needs and this can help you to better manage your blood sugar levels.


  1. Monitor your blood sugar regularly

This is to ensure that your blood sugar doesn’t go way too high or too low.



  1. Berbudi A, Rahmadika N, Tjahjadi AI, Ruslami R. Type 2 diabetes and its impact on the immune system. Current Diabetes Reviews. 2020;16(5):442–9.
  2. Dowey R, Iqbal A, Heller SR, Sabroe I, Prince LR. A bittersweet response to infection in diabetes; targeting neutrophils to modify inflammation and improve host immunity. Frontiers in Immunology. 2021;12.
  3. Medical Nutrition Therapy Guidelines for Type II diabetes 2013. KKM Malaysia
  4. Standards of Medical Care in Diabetes 2021. American Diabetes Association (ADA)
  5. Diabetes Education Manual 2020. Malaysian Diabetes Educator Society


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