From inflammation to intervention: exploring shared mechanisms and lifestyle strategies in diabetes mellitus and...

Diabetes mellitus (DM) and multiple sclerosis (MS), while affecting metabolic and neurological systems respectively, share convergent immunometabolic pathways. This review synthesizes recent evidence elucidating overlapping mechanisms linking DM and MS, emphasizing metabolic dysfunction and systemic inflammation, with therapeutic potential of lifestyle interventions alongside pharmacotherapy. A comprehensive literature analysis examined shared pathogenesis through recent studies. We propose a novel conceptual framework integrating behavioral drivers, metabolic dysregulation, and central nervous system (CNS) pathological outcomes, demonstrating how DM-related immunometabolic stressors promote MS development. Key findings reveal that diabetic metabolic disturbances, including hyperinsulinemia, insulin resistance, and chronic inflammation, potentiate neurodegenerative processes in MS through shared pathways such as nuclear factor kappa B (NF-κB), NOD-, LRR- and pyrin domain-containing 3 (NLRP3) inflammasome, and blood-brain barrier (BBB) dysfunction. Sedentary behavior, excessive adiposity, and Western dietary patterns emerge as modifiable risk factors promoting pro-inflammatory states. Evidence supports that lifestyle interventions, particularly Mediterranean-style diets and regular physical activity, attenuate inflammation, enhance insulin sensitivity, and preserve neurological function in both diseases. DM and MS are united by shared inflammatory and metabolic mechanisms that accelerate disease progression. Beyond pharmacological management, lifestyle modifications represent clinically impactful, sustainable strategies. Integrating dietary and exercise interventions into standard care models signifies a paradigm shift toward proactive, personalized disease modulation.