Arthritis and Diabetes - Understanding the Connection

Arthritis Affects About Half of People With Diabetes

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Arthritis affects approximately 50% of people with diabetes. People with diabetes have twice the risk of developing arthritis compared to those without diabetes. Those are significant statistics because arthritis can be a barrier to physical activity which can benefit both conditions. According to the Centers for Disease Control and Prevention (CDC), about one-third of those who have both arthritis and diabetes rarely or never exercise. Also, adults with both conditions were 30% more likely to be physically inactive than those with diabetes alone.

Rheumatoid Arthritis, Osteoarthritis, and Diabetes

Rheumatoid arthritis and osteoarthritis are both associated with diabetes, but in different ways:

  • Type 1 diabetes (also called juvenile diabetes) is classified as an autoimmune disease, as is rheumatoid arthritis. In patients with type 1 diabetes, the body attacks the pancreas and it cannot produce enough insulin. In rheumatoid arthritis, the synovial lining (i.e., lining of the joints) -- and in some cases, the organs -- is attacked by the body. Rheumatoid arthritis is a systemic disease. Inflammatory markers are elevated in patients with type 1 diabetes, as well as in patients with rheumatoid arthritis.
  • There is an association between osteoarthritis and type 2 diabetes (also called adult-onset diabetes). According to the American Diabetes Association, type 2 diabetes is the most common form of the disease. With type 2 diabetes, the body does not use insulin properly -- known as insulin resistance. Initially, the pancreas produces extra insulin to compensate. Eventually, though, the pancreas isn’t able produce enough insulin to maintain normal blood glucose levels. The common factor in both osteoarthritis and type 2 diabetes? Obesity. Just as overweight and obesity are known to burden the joints, it also burdens the organs. The pancreas is forced to produce increasing amounts of insulin to control excess sugar. Inflammatory chemicals are released by fat cells. At some point, the body can't control what is out of balance.

Research findings have suggested that inflammation and insulin resistance are connected or related -- and both are associated with cardiovascular risk, too. Treatments used to lower inflammation, such as DMARDs (disease-modifying anti-rheumatic drugs) and TNF blockers, may lower the risk of type 2 diabetes in people with rheumatoid arthritis. More studies are needed.

A study, published in the January-February 2015 issue of Clinical and Experimental Rheumatology, evaluated the results of 11 case-control studies and 8 cohort studies. The conclusion from the meta-analysis was that rheumatoid arthritis increases the risk of both type 1 and type 2 diabetes. Again, there is more research to be done.

What You Need to Do

Clearly, to control the two conditions, maintaining your ideal weight is essential, as is regular physical activity. Physical activity helps to improve physical function and improves glucose tolerance. The CDC recommends that people with both conditions should participate in self-management education programs and physical activity programs. Contact your local chapter of the Arthritis Foundation to see what's available in your area.

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