There’s research that suggests a connection between rheumatoid arthritis (RA) and diabetes. But the nature of that connection or even whether it’s actually real is unclear. "There are tantalizing links between the two diseases,” says Daniel Solomon, MD, MPH, an associate professor of medicine at Harvard Medical School and a rheumatologist at Brigham and Women's Hospital in Boston. But "at this point they are mainly speculative."
WebMD asked Solomon and Androniki Bili, MD, MPH, to explore the possible connection between RA and diabetes. Bili is an associate rheumatologist at Geisinger Health System in Danville, Pa. Here is what they had to say and how it might affect the way you manage RA.
Rheumatoid arthritis (RA) is perhaps the most common inflammatory arthritis in the world, says Gary S. Firestein, MD, professor of medicine, dean and associate vice chancellor of translational medicine at the University of California, San Diego School of Medicine. In the United States, an estimated 1.3 million people have the disease, and it affects two to three times as many women as men. And RA may be on the rise in women, according to a 2010 Mayo Clinic study. After decades of decline, the incidence...
There are a number of theories about the connection between diabetes and rheumatoid arthritis. RA is an autoimmune disease. The immune system defends the body from invading organisms and substances that can cause damage. With RA, the body’s immune system attacks its own joints. The result of that attack is an ongoing inflammation, which is a hallmark of RA. Some research suggests that inflammation may also play a role in the onset of diabetes.
Solomon tells WebMD that there are links between inflammation and insulin resistance. "We know there is an increased risk of insulin resistance among people with RA," he says. Insulin is produced in the pancreas and helps the body use glucose, or blood sugar, for energy. In people with insulin resistance, the body’s cells don’t respond to insulin in the correct way. That increases the risk of developing type 2 diabetes.
But inflammation is not the only potential link between RA and diabetes. Certain drugs that are used to treat RA, namely steroids, may actually increase the risk of diabetes. "We need to be very aware of RA patients' glucose levels, especially if they are on corticosteroids,” says Solomon. “This drug is a risk factor for hyperglycemia or high blood sugar levels."
The effects of RA may also increase the risk of diabetes. People with RA may lead sedentary lives due to pain and RA-related disabilities. When people are physically inactive, they are more likely to be overweight. Being overweight or obese is a known risk factor for diabetes. And according to the CDC, the inactivity caused by arthritis interferes with management of both RA and diabetes.