Diabetes More Common in PsA Than RA

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Researchers writing in Arthritis Care and Research this week report that rheumatoid arthritis (RA) patients actually have a lower rate of type 2 diabetes mellitus (T2DM) as compared to people without RA or patients with hypertension, osteoarthritis and psoriatic arthritis.

The findings, which were led by Seoyoung C. Kim, M.D., of Brigham and Women’s Hospital in Boston, were published August 4.

The report is based on an analysis of data from an insurance database from 2005 to 2017. It included 449,327 patients with either a confirmed rheumatoid arthritis diagnosis who were taking at least one disease‐modifying antirheumatic drug (DMARD), or patients with a diagnosis of hypertension, osteoarthritis or psoriatic arthritis. The primary outcome was a diabetes diagnosis with prescription treatment.

Over the course of a 1.6 year follow-up, the RA patients were found to have the lowest incidence rate of T2DM (seven per 1,000 person years), but a T2DM diagnosis was highest among patients with hypertension (12.3 patients per 1,000 patient years. Rheumatoid arthritis was associated with a 24‐35 percent lower risk of incident T2DM compared to the other groups.

"While systemic inflammation in RA increases the risk of cardiovascular disease, our findings suggest that having RA itself does not confer an increased risk of T2DM. Future study should determine whether untreated RA or undertreated RA is associated with a greater risk of developing T2DM," Dr. Kim and colleagues wrote.

Previous studies have shown a modest to no increase in the incidence of type 2 diabetes among rheumatoid arthritis patients. And, while rheumatoid arthritis patients do have a higher risk of cardiovascular disease---this is most likely due to the inflammatory process associated with RA. This study did, however, demonstrate a higher risk of diabetes in patients with hypertension and psoriatic arthritis, but lowest in RA patients in general by 24-35 percent as compared to the three comparator groups.

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REFERENCE

Yinzhu Jin Sarah K. Chen Jun Liu Seoyoung C. Kim. "Risk of incident type 2 diabetes among patients with rheumatoid arthritis: a population‐based cohort study," Arthritis Care & Research. First published Aug. 4, 2020. https://doi.org/10.1002/acr.24343