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Gout and Diabetes

By Elizabeth Shimer Bowers
WebMD Feature
Reviewed by David Zelman, MD

Once termed “the kings’ disease,” gout used to be a problem primarily for wealthy people and royalty who lounged around drinking wine and eating rich food. But today, an estimated 68% of American adults are either overweight or obese. As a result, gout and type 2 diabetes -- two diseases that can result from an unhealthy lifestyle -- are sharply on the rise.

Gout is an arthritic condition caused by having an excess buildup of uric acid. It causes sudden, extreme attacks of pain, swelling, and redness. Gouty arthritis most often strikes the big toe, but it also can show up in the feet, ankles, knees, hands, and wrists.

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Type 2 diabetes, a disease characterized by high levels of sugar in the blood, also can result from eating too much and moving too little.

Gout and type 2 diabetes often co-exist in people with common physical characteristics and conditions, the most prominent being obesity.

“A lot of the risk factors for type 2 diabetes are the same for gout,” says Michele Meltzer, MD, an assistant professor of medicine at Thomas Jefferson Hospital in Philadelphia who specializes in gout. By changing these risk factors, you can help prevent or fight both diseases.

Here’s what you can do:

  • Lose weight. “We are digging our graves with our forks in this country,” says John D. Reveille, MD, director of the division of rheumatology at UT Health Medical School in Houston. To prevent gout, type 2 diabetes, and a host of other health problems, he says you should keep a close eye on your body mass index (BMI) and waist circumference. According to the National Institutes of Health, waist size becomes very important when a person’s body mass index (BMI) is between 25 and 34.9. A BMI over 25 is considered overweight, and a BMI greater than 30 is considered obese. Keep your waist size below 35 inches if you are a woman and 40 inches if you are a man.
  • Exercise regularly. Regular exercise will help control weight and lower high blood pressure, both of which will lower your uric acid level and therefore lessen your chance of developing gout. “Plus, it’s well documented that exercise improves the glucose intolerance associated with type 2 diabetes,” Reveille says. He recommends 30 minutes of moderate activity, at least five days a week. If you're having an acute gout attack or have damaged joints from weight issues, some activities may be difficult. Talk to your health care provider about the best exercise plan for you.
  • Skip the alcohol. A landmark study done by researchers at Massachusetts General Hospital examined the connection between drinking beer and gout. They found that people who drank two to four beers per week were 25% more likely to develop gout. And those who averaged at least two beers a day had a 200% higher risk. “Beer and hard liquor appear to cause a rise in uric acid levels,” Meltzer says. The same doesn't appear to be true with wine, however. Binge drinking is also a very strong risk factor for gout. “Plus, people who eliminate their two beers a day drop weight very quickly, which lowers risk of type 2 diabetes. So you get a two-for-one by cutting out the beer,” she says.
  • Avoid sugar-sweetened beverages. Early research suggests that beverages sweetened with sugar or high-fructose corn syrup, such as regular soft drinks, may increase the chances of developing gout. Even orange juice may increase gout. Eliminating sugary beverages is also a great way to cut calories from your diet, shed a few pounds, and improve your diabetes.
  • Go on a gout diet. A gout diet aims to control uric acid production by reducing intake of foods high in purines. High-purine foods create increased levels of uric acid in the body. Some of the worst high-purine foods are liver and other organ meats, as well as anchovies. Other foods to avoid include lobster, shrimp, scallops, herring, mackerel, beef, pork, and lamb. Don't worry about cutting out purines completely. Just eat these foods in moderation: No more than one serving daily.
  • Eat more dairy. Some studies have shown that drinking skim or low-fat milk or eating low-fat dairy products can help reduce risk of gout, Meltzer says. There is evidence that eating low-fat dairy helps lower risk of type 2 diabetes as well. Aim for 16 to 24 fluid ounces of dairy per day.
Reviewed on October 31, 2011

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