[ Diabetes Type 1 ]

Deep Dive: Diabetes and Rheumatoid Arthritis

We conducted a cohort study using an electronic medical records database representative of the UK general population (1986-2010). At the beginning of the trial patients had not been treated for their RA, and were randomized to begin treatment with prednisolone at 60 mg/day or 30 mg/day. Dr Wasko reported receiving contractual reimbursement as site principal investigator for an Aventis-sponsored clinical trial of leflunomide in rheumatoid arthritis, ending in November 2002. Controls met the same criteria but were ulcer naive. Those who had T2D before RA were excluded. In RA, the inflammation causes joints to become swollen, painful, and stiff. Being on the team meant that I was to meet the group at 7:0 AM.

Your doctor may also recommend a calcium and vitamin D supplement, but will probably advise that you avoid any over-the-counter herbal remedies. Patients with RA were less likely to have a CV event than were patients with DM for procedures of low risk (3.38% versus 5.30%; P < 0.001) and intermediate risk (0.34% versus 1.07%; P < 0.001). Wagner also sees broader applications for cord blood in autoimmune diseases, in which the body’s immune system mistakenly attacks healthy tissue. Further work is needed to determine its potential preventive role in other groups at high risk for diabetes. There was significant correlation between HOMA-IR and body mass index, hypertension and C-reactive protein, but no correlation was seen with the homeostasis model of assessment of beta cell function. All adult (age ≥18 years) individuals with a new diagnosis of RA within the Geisinger Health System between January 1, 2001, and December 31, 2009, were included. Like type 1 diabetes, RA is an autoimmune disease. In fact, RA is the most common autoimmune disease in the world, impacting about 1% of the global population. To put that into perspective, there are about 7.4 billion people on the planet so 1% would be 74 million people. We found that only 3 out of 39 (7.7%) patients with RA had microalbuminuria, comparable to controls reported in other microalbuminuria studies [3] (Table 1). (Apparently there’s no single country on the globe boasting a population of 74 million, so I had to punt.) Still, That’s a bunch of people. Similar to the way the immune system attacks the beta cells in T1 diabetes, with RA, the immune system attacks the tissue of the joints causing them to become inflamed. An anti-nuclear antibody test can show whether the protein is present in the blood. At first RA affects the small joints in the hands and feet, the connecting joints that attach the fingers to hands, and the toes to feet. It would also be interesting to see which disease was diagnosed first, or which presented symptoms first. Most of these microbes live in the gut. Joint damage begins within two years of onset, and by the time a decade has passed, 60% of people afflicted are too crippled to work. And for some people the attack doesn’t stop at the joints. It goes beyond joint tissue and degrades organ systems including the skin, the eyes, the lungs, and even the blood vessels. In one of these studies [53], the reported prevalence of HT of 62% would have been higher if patients on lipid-lowering agents and therapy for diabetes had not been excluded. RA usually strikes after age 40.

Phillips was 42, but thinks he must have had it for a few years prior to the point that his doctor got it sorted out. Although he was fairly typical in that respect, he’s squarely in the minority in one other way: RA is much more common among women than it is among men. RA is a disease that pulses, that comes and goes like the tide. “You can only do what you can do — not ideal, but you need to know your body’s limits.” Listen to your doctor and your body. A flare is an acute attack of symptoms with increased pain, swelling, and stiffness. After it subsides, the patient is “normal” for a time, but the flares always return, and they increase in frequency and intensity over time. A discussion of RA treatment would take a Deep Dive article of its own, but suffice it to say that there are a limited number of medications that can be used.

Nervous system problems. But all the meds have a limited shelf life. But now, I can’t wait to go!!! Fish oil supplements may also be helpful as they contain a certain type of fat called omega-3. Oh, and most of these drugs are crazy-expensive. Bankruptcy expensive. Check out this article from our sister site if you’re feeling sorry for yourself about the cost of your insulin.

Some biologic RA treatments carry a $10,000 price tag, and on average, copays for RA patients run $2,700 annually. The meds also boast frighteningly long lists of possible side effects. How common is it for people like Phillips to have both diabetes and arthritis? To relieve fibromyalgia pain, doctors often prescribe drugs that fix the balance in the neurochemicals. According to the Arthritis Foundation people with any sort of diabetes are nearly twice as likely as sugar normals to be diagnosed with some variety of arthritis, and diabetes researchers have estimated that about half of people with diabetes have a dual diagnosis. So which came first, the chicken or the egg? Well, mixing our metaphors, but sticking with feathers, it seems the stork just delivered both at the same time.

So far, there’s no evidence that one causes the other. They just seem to like to hang out together, at least when it generically comes to diabetes and arthritis. But when looking at the two specifically autoimmune types of diabetes and arthritis (T1D and RA), the pair Phillips has, new research suggests that the two conditions might have some genes in common. Specifically, without diving so deep that I drown, they both share a gene that controls a phosphorylase enzyme that may trigger “over reactivity” of the immune system—suggesting the possibly that one gene is the driving engine of the autoimmune attack behind both diseases. Clearly, DM and RA together are a heavy burden. But which is the heavier load? I asked Phillips: If the Genie in the Bottle could take away only one of the two diseases from you personally, which would you choose?

One man, one sufferer’s opinion. But what about the bigger picture? Next I asked Phillips: What if the Genie’s supervisor could take away only one of the two diseases from the entire planet? Would he make the same choice? This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn’t adhere to Healthline’s editorial guidelines. For more information about Healthline’s partnership with Diabetes Mine, please click here.

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