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Insulin signaling directly influences immune cell metabolism, macrophage polarization, and T-cell differentiation, thereby shaping inflammatory responses within musculoskeletal tissues ( Increasing evidence from immunometabolic research supports a bidirectional relationship between metabolic dysfunction and inflammatory arthritis, whereby chronic inflammation promotes insulin resistance, which in turn amplifies synovial and entheseal inflammation ( Figure 1 , insulin resistance, adipose tissue inflammation, and impaired incretin signaling converge at the skinjoint axis to amplify IL-23/IL-17driven immune activation and disease progression

During a trip to Miami last year, Fatima [not her real name] found herself driving in circles downtown, feeling like her brain was broken. Shed left the house for a quick coffee run and returned 45 minutes later

These tests may include a urine and blood test to check for an overactive thyroid or low blood sugar