Increased Risk for Diabetes in Patients With Poorly Controlled Rheumatoid Arthritis

Share this content:
Patients with concomitant RA and T2D are at increased risk for developing CVD.
Patients with concomitant RA and T2D are at increased risk for developing CVD.

According to a study published in PLoS ONE, patients with rheumatoid arthritis (RA) have an increased short-term risk of developing type 2 diabetes (T2D).

In patients with RA, T2D remains significantly underdiagnosed and undertreated, which increases the risk of developing cardiometabolic comorbidities.

A single-center, prospective study was designed to determine the prevalence of T2D in patients with RA over the course of a year, estimating the occurrence of new T2D diagnoses while taking into consideration traditional cardiovascular and RA-specific related risk factors.

Four hundred thirty nine consecutive patients with RA were enrolled in the trial; 7.1% (31/439) developed T2D within 1 year of follow-up. 

The presence of high blood pressure (odds ratio [OR], 6.83; 95% CI, 2.18±21.34, P =.001), impaired fasting glucose (IFG) at first observation (OR, 30.55; 95% CI 6.53±142.76, P <.0001), and poor EULAR-DAS28 response at 1 year follow-up (OR, 33.59; 95% CI: 6.95±162.21, P <.0001) were all significantly associated with a higher risk of developing T2D.

High Yield Data Summary

  • The presence of high blood pressure, IFG at first observation, and poor EULAR-DAS28 response at 1 year follow-up were significantly associated with a higher risk of developing T2D.
  • The presence of high blood pressure and poor EULAR-DAS28 response after 1 year of follow-up were significantly associated with the risk of IFG.

After 1 year of follow-up, more than 7% (34/439) of participants had IFG, with regression analysis showing the presence of high blood pressure (OR, 5.71; 95% CI 1.40±23.27, P =.015) and poor EULAR-DAS28 response (OR, 75.22; 95% CI:23.33±242.72, P <.0001) being significantly associated with the risk of IFG (χ2 = 128.73, P <.0001).

Patients with both RA and T2D are at even higher risk for developing cardiovascular disease (CVD) and are at increased risk for CVD-related mortality. The researchers suggest that finding risk factors for T2D in patients with RA could assist in overall CVD risk reduction and management.

Limitations

Limitations of this study include:

  • Lack of a control group, which prevents the quantification of the relative risk of new-onset T2D and IFG compared with randomly selected patients from the general population;
  • Short follow-up period, which limits investigation of the correlation between glucose intolerance and observable cardiovascular outcomes; and
  • Lack of oral glucose tolerant test data, which results in the potential misclassification of a small subset of patients with impaired glucose tolerance as normal.

follow @RheumAdvisor

Reference

Ruscitti P, Ursini F, Cipriani P, et al. Poor clinical response in rheumatoid arthritis is the main risk factor for diabetes development in the short-term: A 1-year, single-centre, longitudinal study. PLoS ONE. 2017;12(7):e0181203.


You must be a registered member of Rheumatology Advisor to post a comment.

Sign Up for Free e-newsletters