Rheumatoid arthritis (RA) is a systemic inflammatory disease. Though it primarily attacks the joint, it can affect the entire body including non-joint structures. Sometimes it may also coexist with another serious health condition, making it more difficult to deal with. Can it also affect your blood sugar and cause diabetes?
Poorly-controlled RA can lead to a number of serious complications. And again, it can also affect other parts of the body that have nothing to do with your joint. So, it’s important to control the disease.
The good news, new treatments work more effectively. They can help turn the disease into a manageable condition, though curative therapy is not available yet. The goal of treatment is to drive the disease go into remission (periods of little /no symptom).
More flare-ups (periods of when the symptoms get worse) that occur, the higher the risk for the complications to occur. With prompt treatment, RA remission can last in months or even years.
Staying on top of your RA treatment is always worth a try to keep the disease under control, though this might seem like an inconvenience at times. Without prompt treatment, the disease can turn into serious or even life-threatening.
The following are some complications of untreated RA:
- It can lead to long-term damage to the affected joints. At first, it tends to attack the smaller joints. Over time, it can also affect larger joints, causing irreparable damage with persistent pain & disability.
- Osteoporosis (bone fractures).
- Sjogren’s syndrome (dry mouth eyes).
- You’re more vulnerable to get infections. The abnormality of immune system in RA can increase the risk of infection, because your immune system goes awry and doesn’t work normally.
- Untreated RA in long term could be life-threatening, too. Because it may lead to narrowed blood vessels, heart disease, lung disease, or even lymphoma (a kind of blood cancer that attacks lymph system)!
With prompt treatment, the complications are preventable and people with RA can have a good control of their symptoms. They can also have an average expected lifespan!
Diabetes is a disorder that affects the way of how your body uses glucose (sugar). Your cells need plenty of energy to make muscles and tissues. And glucose is the main source of this energy. Even it’s also the main source of fuel for your brain.
If you have diabetes, your body cannot use glucose for energy effectively. Glucose is more likely to stay /accumulate in the circulation (bloodstream) and your blood sugar level increases (higher than normal). And chronic episodes of high blood sugar levels can be dangerous for many tissues /organs of the body.
There are several types of diabetes. The main ones are type-2 and type-1 diabetes. Type-2 diabetes is the most common form of diabetes. It is much more common than type-1.
The exact way of how type-1 occurs is not known. But many experts believe that it’s associated with the abnormality of immune system. Therefore it’s also often called as ‘autoimmune disease’.
Normally, your immune system is responsible to fight against any harmful viruses or bacteria. But in type-1 diabetes, the immune system usually goes awry and mistakenly attacks the pancreas’s insulin-producing cells. As a result, the pancreas cannot produce insulin normally.
While the exact cause is still unclear, it’s thought that the disease may run in families. People with a family history of type-1 diabetes have a higher-than-normal risk for developing the same problem.
It occurs when you have insulin resistance, a condition in which cells of your body become more resistant to the action of your insulin hormone. Your pancreas may also not be able to produce enough insulin to deal with this resistance. If insulin doesn’t work effectively, your blood sugar increases more easily.
Type-2 diabetes is not autoimmune disease. It’s more likely to be associated with lifestyle factors, though it also tends to run in families. These lifestyle factors include:
- Poor diet, especially if you get used to diet high in sugar.
- Many people with type-2 diabetes are obese.
- Poor in exercise (lack of physical activity). A sedentary lifestyle is bad for insulin sensitivity in long term. It is also not good for your weight control.
Other risk factors:
- Age, the risk of having type-2 diabetes increases with age.
- The disease is relatively more common in certain races such as American Indians, Hispanics, blacks, and Asian-Americans.
Certain health conditions may also increase the risk. These include high blood pressure, abnormal levels of triglyceride and cholesterol levels, and polycystic ovary syndrome (in women). How about RA?
RA and diabetes share some similar risk factors. Non-modifiable risk factors such as gender, age, and genetics can put you at high risk of developing RA or diabetes (especially type-2 diabetes) – as well as modifiable risk factors such as overweight /obesity.
Another thing that takes attention is immune system abnormality. RA is autoimmune disease – it is associated with the malfunction of immune system, as noted before. With RA, your immune system mistakenly attacks your healthy joints, causing inflammation and painful joints. And again, the effect of this malfunction is systemic. It can affect your entire body, including your insulin.
Even according to some studies, RA may cause increased risk of type 2 diabetes by about 50 percent. In other words, people with RA have about 50 percent more likely to have diabetes (if compared to people without autoimmune disease).
Studies suggest that systemic inflammation of RA may have a role in the onset of diabetes. Some experts believe that the disease can increase the risk of insulin resistance. The bad news, certain RA treatments may worsen the risk. Steroid (corticosteroid), for example, is a risk factor of high blood sugar levels.
Furthermore, it’s possible to have more than one autoimmune disorder. Both RA and type-1 diabetes are autoimmune diseases. They can occur together, thought this is not common.
What else? The effects of your RA may also have a role to put you at high risk of diabetes. For example, discomforts or even disabilities with your joint will drive you to become a sedentary individual, which is bad for your muscle weight and insulin sensitivity.
Though there are some explanations about this connection, the exact way of how RA increases the risk of diabetes is not fully understood yet. There are many tantalizing links that still remain puzzling, making this issue more difficult to understand.
But having RA doesn’t mean that you will definitively become a diabetic. The complications, including diabetes, are preventable. To keep the risk of diabetes at bay, here are major checklists to remember for people with RA: