Testing Blood Sugar Diabetes

What do rheumatoid arthritis (RA) and type 2 diabetes have in common? The answer is inflammation, and it might explain why people with RA are 23 percent more likely than the general population to develop type 2 diabetes, according to a study that pooled data from several other studies (known as a meta-analysis).

Unlike type 1 diabetes (and rheumatoid arthritis), type 2 diabetes is not believed to be an autoimmune condition. But there are many possible causes of excess inflammation besides an inappropriate immune response. Too much inflammation has been tied to a wide range of health problems, including type 2 diabetes.

Researchers from the University of Manchester in the UK conducted a meta-analysis of studies that looked at the connection between RA and type 2 diabetes to learn about how often the conditions overlapped. The studies they analyzed included data on a total of nearly 1.7 million participants.

According to the results, which were presented at the 2020 annual meeting for the European Association for the Study of Diabetes, the connection between RA and type 2 diabetes is strong: They found that having RA is associated with a 23% increased risk of type 2 diabetes.

“This finding supports the notion that inflammatory pathways are involved in the pathogenesis of diabetes,” the researchers concluded. “We suggest that more intensive screening and management of [type 2 diabetes] risk factors should be considered in people with RA.”

In other words, the systemic inflammation from RA could raise the likelihood of someone developing diabetes in the future. Rheumatoid arthritis also causes chronic joint pain and stiffness that can make people less physically active, which can further contribute to diabetes risk.

The researchers noted to Healio Rheumatology that despite this association, “many national guidelines for rheumatoid arthritis did not recommend assessing diabetes status and its risk factors.”

“We want to raise awareness of this link,” study author Adrian Heald, MD, told Healio. “If health care providers have someone with rheumatoid arthritis in front of them, be aware that individual is at elevated risk for developing prediabetes or type 2 diabetes in the future and the basic HbA1c screening test needs to be done, and even a lipid profile screening.”

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Schaffer R. Rheumatoid Arthritis May Increase Type 2 Diabetes Risk. Healio Endocrinology. September 22, 2020. https://www.healio.com/news/endocrinology/20200922/rheumatoid-arthritis-may-increase-type-2-diabetes-risk.

Study Shows that Rheumatoid Arthritis is Associated With a 23% Increased Risk of Developing Diabetes. EurekAlert! September 20, 2020. https://www.eurekalert.org/pub_releases/2020-09/d-sst_1091720.php.

Tian Z, et al. The relation between rheumatoid arthritis and diabetes incidence: a systematic review and meta-analysis. Diabetologia. September 2020. Doi: https://doi.org/10.1007/s00125-020-05221-5.

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