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How Rheumatoid Arthritis Can Affect Your Blood Sugar

By

Linda Wasmer Andrews

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When you hear the word “arthritis,” you probably think of joint pain, swelling and stiffness. But rheumatoid arthritis (RA), a disease that causes inflammation in your joints, can affect the rest of your body, too—sometimes in surprising ways. For example, studies have shown that people with RA are more likely to also have diabetes, a condition characterized by high blood sugar levels.

From Joint Pain to Blood Sugar Woes

It turns out that inflammation, which is a key feature of RA, may cause a buildup of sugar in the blood.

Luckily, there’s a silver lining to the relationship between RA and blood sugar: Certain things that help manage your RA, like some lifestyle choices and medications, may also help prevent or control diabetes.

Inflammation and Insulin Resistance

So, how can inflammation lead to high blood sugar? The answer has to do with insulin.

Insulin is a hormone that helps a person’s cells absorb sugar from the blood so it can be used for energy. If the cells are unable to use insulin effectively, a condition known as insulin resistance, excess sugar can start to build up in the blood. Eventually, the person may develop type 2 diabetes.

Remember that RA can cause widespread inflammation throughout the body. This inflammation, in turn, may increase the body’s risk of developing insulin resistance.

Researchers are still studying exactly how inflammation contributes to insulin resistance. Two likely culprits are tumor necrosis factor (TNF) and interleukin-6 (IL-6), proteins that are involved in joint inflammation. There’s evidence that both TNF and IL-6 may interfere with insulin’s ability to work properly.

Tips to Help Manage Both Conditions

Having RA doesn’t automatically mean you’ll develop insulin resistance or diabetes. But your risk is increased, so making healthy choices is crucial. Start with these steps, which are good for both your joint health and your blood sugar:

  • Keep moving. Ask your doctor for advice on exercising safely and successfully with RA. Staying active helps maintain your strength and flexibility, and it also helps manage your pain and control your weight. Plus, regular exercise reduces your risk of developing type 2 diabetes. If you already have diabetes, an active lifestyle helps keep your blood sugar under better control.

  • Lose weight. Drop those extra pounds to take pressure off your hips and knees, which may ease your RA symptoms. Losing weight can also reduce the amount of inflammatory chemicals in your body that are made by fat. If you’re at high risk of getting type 2 diabetes, you can lower your risk by losing weight. And if you already have diabetes, you may find that you need a lower dose of diabetes medicine when you exercise consistently.

RA Medicines that Affect Blood Sugar

Talk with your doctor about how your RA medication may be affecting your blood sugar. Corticosteroids—such as prednisone (Prednisone Intensol, Rayos), prednisolone (Millipred, Orapred, Pediapred, Prelone, Veripred 20) and methylprednisolone (Medrol)—can cause increased blood sugar levels as a side effect. To minimize side effects, corticosteroids are usually prescribed for the shortest possible time at the lowest effective dose.

In contrast, certain other RA drugs may actually reduce the risk of developing insulin resistance or diabetes. They include:

  • Hydroxychloroquine (Plaquenil), which modifies the course of RA
  • TNF inhibitors—such as adalimumab (Humira), certolizumab (Cimzia), etanercept (Enbrel), golimumab (Simponi) and infliximab (Remicade)—which block the inflammatory protein TNF
  • Tocilizumab (Actemra), which blocks the inflammatory protein IL-6
  • Abatacept (Orencia) is an elective T-cell costimulation blocker

Working with your doctor to take care of your RA can really pay off—you could be helping your blood sugar stay in check, as well.

Key Takeaways

  • Studies have shown that people with rheumatoid arthritis (RA) are more likely to have diabetes than those without RA.

  • RA can cause widespread inflammation throughout the body. This inflammation, in turn, may increase the body’s risk of developing insulin resistance, which can lead to type 2 diabetes.

  • Fortunately, certain lifestyle choices and medications that help control RA may also help prevent or control diabetes.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Sep 20, 2017

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Medical References

  1. Choy E, et al. Cardiovascular risk in rheumatoid arthritis: recent inflammation, risk predictors and the impact of treatment. Rheumatology. 2014;53(12):2143-54.
  2. Dubreuil M, et al. Diabetes incidence in psoriatic arthritis, psoriasis and rheumatoid arthritis: A UK population-based cohort study. Rheumatology. 2014;53:346-52.
  3. Ogata A, et al. Safety and efficacy of tocilizumab for the treatment of rheumatoid arthritis. Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders. 2012;(5):27-42.
  4. Solomon DH, et al. Association between disease-modifying antirheumatic drugs and diabetes risk in patients with rheumatoid arthritis and psoriasis. JAMA. 2011;305(24):2525-31.
  5. Rheumatoid Arthritis Treatment. Arthritis Foundation. http://www.arthritis.org/about-arthritis/types/rheumatoid-arthritis/treatment.php
  6. Inflammatory Arthritis and Diabetes: Managing Both. Arthritis Foundation. http://www.arthritis.org/living-with-arthritis/comorbidities/diabetes-and-arthritis/rheumatoid-arthritis-diabetes-risk.php
  7. How Fat Affects Arthritis. Arthritis Foundation. http://www.arthritis.org/living-with-arthritis/comorbidities/obesity-arthritis/fat-and-arthritis.php
  8. Biologics Overview. Arthritis Foundation. http://www.arthritis.org/living-with-arthritis/treatments/medication/drug-types/biologics/drug-guide...
  9. Corticosteroid use in rheumatoid arthritis. Arthritis Foundation. http://www.arthritis.org/living-with-arthritis/treatments/medication/drug-types/corticosteroids/ra-c...
  10. Arthritis Comorbidity Statistics. Centers for Disease Control and Prevention. https://www.cdc.gov/arthritis/data_statistics/comorbidities.htm
  11. Physical activity and health. Centers for Disease Control and Prevention. https://www.cdc.gov/physicalactivity/basics/pa-health/
  12. Physical activity is important. American Diabetes Association. http://www.diabetes.org/food-and-fitness/fitness/physical-activity-is-important.html
  13. Rheumatoid Arthritis. National Institutes of Health. National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov/health-topics/rheumatoid-arthritis
  14. Symptoms and Causes of Diabetes. National Institutes of Health. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/symptoms-causes

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