In the laboratory, the researchers studied cultured cells from a human aorta, the blood vessel that comes out of the heart and goes to the rest of the body. They put the cells in a high-glucose environment””similar to a what happens inside a diabetic body””and found that without inflammation present, sugar didn’t enter the cells. And even when glucose was forced into the cells, the cells weren’t damaged.But inflammation changes everything. When researchers added an inflammatory protein called interleukin-1””a common marker for inflammation in the body, whether you are diabetic or not””the cell did metabolize the glucose, which kicked off a cycle of inflammation. Those effects were blocked once the researchers gave the cells a certain type of anti-inflammatory drug.“What [the study authors] said was, you need the inflammation in order for the glucose to do the damage to the cells,” explained Mary Ann Bauman, MD, a primary care internist at INTEGRIS Health in Oklahoma City and a spokesperson for the American Heart Association. (Dr. Bauman was not an author on the study.) “That could be one of the reasons why in a diabetic, if we can get them to exercise and lose weight, they will have less damage to their blood vessels.”

In diabetes care, doctors and patients often focus on reducing blood sugar levels, and though this preliminary research occurred only in cells, it shows how inflammation might play a role, Dr. Bauman said.

That means that controlling blood sugar isn’t always enough to avoid the cardiovascular disease that sometimes stems from diabetes, and anti-inflammatory drugs may one day be able to help, said study author Carlos Sánchez-Ferrer, professor of pharmacology at the Universidad Autónoma de Madrid in Spain, in a press release. Lifestyle changes can help, too. “We need to reduce the inflammatory environment associated with diabetes,” Sánchez-Ferrer said. “Changes in lifestyle, such as physical exercise and weight reduction, are important not only because they reduce blood sugar but because they reduce inflammation.”