Arthritis Self-Management

Study Finds That RA Raises Diabetes Risk

by David W. Golann
August 19, 2010

People with autoimmune conditions such as rheumatoid arthritis (RA) are at increased risk for diabetes, according to a large study published recently in the online edition of the journal Annals of the Rheumatic Diseases. The study found that people with RA, psoriasis, or psoriatic arthritis were more likely to develop diabetes than people without these conditions.

Scientists class together RA, psoriasis, and psoriatic arthritis because they all involve an immune system that attacks healthy cells in the body. For this reason, they are called autoimmune conditions. In RA, the immune system primarily targets the joints, making them painful and inflamed, and also affects other organs throughout the body. In psoriasis, the immune system attacks the skin, making it scaly and red. People with psoriatic arthritis have joint pain and inflammation along with the skin symptoms of psoriasis.

The study’s researchers examined health data from people in British Columbia from 1996 to 2006. They looked at 48,718 people with RA, 40,346 people with psoriasis or psoriatic arthritis, and 442,033 people without these conditions. At the start of the study period, none of these people had diagnosed diabetes. Throughout the course of the study, the researchers found that people with one of the autoimmune conditions were about 50% more likely to develop diabetes than were people without an autoimmune condition. This discrepancy held true even when age, weight, and use of corticosteroid medicines were taken into account. (Corticosteroids, such as prednisone, are frequently used to treat autoimmune conditions and are known to raise the risk of diabetes.)

What is the connection between RA (and other autoimmune conditions) and diabetes? Researchers aren’t certain, but some speculate that it may have something to do with the body-wide inflammation that RA causes. This inflammation is associated with insulin resistance, a condition in which the body’s cells become resistant to the hormone insulin and are therefore less able to use the energy from food. Insulin resistance is a hallmark of Type 2 diabetes. (In Type 1 diabetes, the underlying problem is that the body no longer produces insulin — a result of an autoimmune attack on insulin-producing cells in the pancreas.)

The connection with diabetes may also have to do with inactivity. People with inflamed joints are less likely to exercise, and lack of exercise is a risk factor for Type 2 diabetes.

People with RA or another autoimmune condition should not interpret this study to mean that they are destined to develop diabetes. The study may, however, add diabetes to the list of conditions that people with inflammatory arthritis are at increased risk for. RA, for example, increases the risk for several conditions, notably heart disease and osteoporosis. People with RA are advised to be aware of these risks and address them through diet and other lifestyle choices. Knowing that there is an association between diabetes and autoimmune conditions only adds incentive for people with autoimmune conditions to maintain a healthy weight and stay active — the most effective ways to prevent Type 2 diabetes.

David W. Golann is the Associate Editor of Arthritis Self-Management.

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