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Rheumatoid Arthritis (RA) and Diabetes

Understanding the RA/diabetes connection.
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RA/Diabetes Connection: Can the Risk Be Lowered?

”If a patient has any modifiable risk factors for diabetes such as obesity,” Solomon says, “I want to be as proactive as possible." This means encouraging the patient to eat a healthful diet and get regular exercise. Doing so will help lose weight and reduce the risk of diabetes.

And treating RA may also play a role in reducing the risk of diabetes. While steroids can increase diabetes risk, other rheumatoid arthritis medications may actually help lower the risk. For example, studies show that the antimalarial drug hydroxychloroquine is associated with a decreased risk of diabetes among people with RA.

In one study, people with RA who had ever taken hydroxychloroquine were 53% less likely to develop diabetes than their counterparts who had never taken it. In another study of patients with RA, researchers  found that having ever taken hydroxychloroquine reduced the risk of diabetes by 38%. What’s more, people with RA who took hydroxychloroquine for more than four years were 77% less likely to report a new diabetes diagnosis than those who never took it.

“This is a safe and inexpensive drug and it has been consistently shown to decrease the risk of diabetes in RA,” says Bili, the author of the first study.

RA/Diabetes Connection: Making Informed Choices to Reduce the Risk

Does the effectiveness of hydroxychloroquine in reducing diabetes risk mean all people with RA and risk factors for diabetes should take it?

“It is a reasonable choice,” Bili says, “but it is a weaker treatment for RA. It may not achieve disease control.” Other drugs are more effective when it comes to treating the pain and inflammation of RA. “But, says Bili, “for people with mild RA who have risk factors for diabetes, it might be reasonable to start treatment with hydroxychloroquine. If they have more severe RA, she tells WebMD, hydroxychloroquine could be taken in combination with another arthritis drug.

It’s not clear why hydroxychloroquine is associated with lower diabetes risk among people with RA. It may allow the hormone insulin to remain in the body longer. This could improve insulin sensitivity and glucose tolerance and prevent diabetes.

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