Rheumatoid Arthritis and Diabetes: Are They Linked?

Rheumatoid arthritis (RA) and diabetes are very different diseases. But they share a connection. Having one may mean you're more likely to develop the other.

In fact, research shows that RA raises your risk for diabetes by about 50%. And diabetes raises your risk of having arthritis, including RA and arthritis-related issues, by about 20%. Nearly half of American adults who have diabetes also have arthritis.

What's the Connection?

Experts aren't sure why these two diseases are linked. They believe that a variety of things play a role, including:

  • RA and type 1 diabetes are both autoimmune diseases. The immune system's job is to destroy germs and other sickness-causing invaders. Sometimes, the system goes haywire and turns against the body's own healthy cells. RA attacks the joints. Type 1 diabetes targets the cells in the pancreas that produce insulin, a hormone that helps your body process blood sugar. Type 1 diabetes is typically diagnosed in children and young adults and makes up less than 5% of all diabetes cases.

    Research suggests that some people tend to have more than one autoimmune disease. This may be partly due to genetics. And scientists have identified a gene that raises the risk for both type 1 diabetes and RA.
  • RA causes chronic inflammation. In the short run, inflammation helps the body heal. But when it's ongoing, it causes the body to stop responding to insulin the way it should. This is called insulin resistance. Over time, the condition raises the risk for type 2 diabetes. This occurs when the body doesn't make enough insulin or resists its effects.
  • Diabetes also triggers inflammation. On the flipside, chronic inflammation from diabetes may pave the way for RA. RA is caused by genetics and environmental factors. Research suggests that inflammation may cause people who have a genetic risk for RA to develop the disease earlier than they would have otherwise.
  • Certain RA drugs may increase your blood sugar. Some drugs that are used to treat RA can raise your risk for diabetes. These include statins and steroids.
  • RA can keep you from moving. The disease causes your joints to become stiff, swollen, and painful. As a result, you may not want to exercise. One study found that 42% of people with RA aren't physically active. Not staying active raises your risk for type 2 diabetes. It may also cause you to pack on pounds. Being overweight or obese are top risk factors for diabetes.

 

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Does One Disease Cause the Other?

The connection between RA and diabetes may be shared risk factors. For example, the same genes that cause one disease may lead to the other. Lifestyle choices such as smoking, exercise, and your weight also can affect your chances of developing both RA and diabetes.

But research suggests that RA itself can lead to diabetes. Experts think that inflammation may be the main culprit. It's not clear if diabetes can lead to RA.

 

Can You Reduce Your Diabetes Risk?

If you have RA, there are things you can do to reduce your risk of developing diabetes:

  • Seek treatment as soon as possible. Taking the right medicine early on can prevent joint damage and inflammation. This can fend off the pain that keeps you from exercising.
  • Keep the disease under control. To keep inflammation in check, take your medications as prescribed. If you're still bothered by your symptoms, speak with your doctor. You may need a different dose or type of drug to treat your RA. 
  • Keep a healthy weight. If you're overweight, losing as little as 7% of your body weight reduces your risk of diabetes.
  • Get active. Exercise lowers your chances of developing type 2 diabetes. Aim to move for 30 minutes a day at least five days a week. Are you just starting out? Start with 5-10 minutes, and then add a little more each week.
  • Eat a healthy diet. Choose foods that are lower in fat and high in fiber. Fill your plate with whole grains, fruits, vegetables, low-fat dairy such as skim milk, and lean protein.

 

RA Treatments and Diabetes Risk

Some medications used to treat RA affect your risk of diabetes. Steroids and statins can raise your blood sugar and make you more likely to develop the disease.

But other RA drugs may protect against diabetes. They include:

  • TNF inhibitors: These drugs block an inflammation-causing substance called TNF. TNF may play a role in the onset of diabetes. One study found that people with RA who took this type of medication were 51% less likely to develop diabetes than those who didn't.
  • Hydroxychloroquine: This malaria medication is also used for RA. It's been shown to lower diabetes risk in people with RA by about 33%.
  • Abatacept: This treatment is often prescribed after other drugs don't work. It lowers inflammation by preventing certain cells from talking to each other. According to research, abatacept reduces the risk of diabetes by about 50%.

 

WebMD Medical Reference Reviewed by David Zelman, MD on June 02, 2017

Sources

SOURCES:

Christopher Morris, M.D., F.A.C.R., rheumatologist, Arthritis Associates of Kingsport, Tenn.; physician, Southern Medical Association.

Annals of Rheumatic Diseases: "The Risk of Diabetes Among Patients with Rheumatoid Arthritis, Psoriatic Arthritis, and Psoriasis," "Risk of diabetes mellitus associated with disease-modifying antirheumatic drugs and statins in rheumatoid arthritis."

American Diabetes Association: "Prevalence of Diagnosed Arthritis and Arthritis-Attributable Activity Limitation Among Adults With and Without Diagnosed Diabetes: United States, 2008–2010,""Physical Activity."

JDRF: "Type 1 Diabetes Facts."

Maedica: A Journal of Medicine: "Multiple Autoimmune Syndrome."

Arthritis & Rheumatology: "A specific association exists between type 1 diabetes and anti- CCP positive rheumatoid arthritis."

Journal of Clinical Investigation: "Inflammation and Insulin Resistance."

Mayo Clinic: "Type 2 Diabetes,""Diabetes Prevention."

PLoS One: "Risk of Rheumatoid Arthritis in Patients with Type 2 Diabetes: A Nationwide Population-Based Case-Control Study."

Clinical & Experimental Immunology: "Early environmental factors and rheumatoid arthritis."

Arthritis Care & Research: "Public health impact of risk factors for physical inactivity in adults with rheumatoid arthritis," "Diabetes mellitus risk in rheumatoid arthritis: reduced incidence with anti-tumor necrosis factor α therapy."

American College of Rheumatology: "Treatments."

 

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