Rheumatoid arthritis (RA) is a type of inflammatory arthritis and autoimmune disorder. People with RA have an increased risk of diabetes, while diabetes can also raise the risk of RA. Excessive inflammation, lifestyle factors, and genetics may be among the factors that connect the two conditions.

RA and diabetes also share several risk factors and causes, including certain medications.

This article discusses the link between RA and diabetes and explains how people can prevent and treat each of these conditions.

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Although diabetes and RA share some similarities in terms of their causes and risk factors, they are very different conditions.

RA is an inflammatory autoimmune disease in which the body’s immune system mistakenly attacks healthy cells and tissue. It often causes inflammation in the joints of the hands, knees, or wrists. In some cases, it may affect the lungs, heart, eyes, or other organs throughout the body.

Type 2 diabetes is the most common form of diabetes. In a person living with the condition, the body either does not produce enough insulin or does not use it effectively. In either case, blood sugar levels will elevate.

Inflammation and TNF buildup

The most likely connection between type 2 diabetes and RA involves inflammation and a buildup of cytokines known as tumor necrosis factor (TNF) in the body. The Arthritis Foundation notes that TNF plays a necessary role in wound healing by causing an inflammatory effect. However, it can be harmful when too much TNF is circulating in the body.

In RA, the immune system’s attack on the joints causes TNF to build up in the body. In type 2 diabetes, fat cells mainly produce TNF, which can cause the body to develop insulin resistance over time. As a result, it is possible that the inflammation and TNF associated with RA could increase the risk of a person developing type 2 diabetes.

Medications and lifestyle

Other possible connections between RA and type 2 diabetes involve medications and lifestyle factors that can act as risk factors for both conditions.

Certain medications, such as corticosteroids, can increase the likelihood of developing type 2 diabetes. Also, RA might lead to a person having a more sedentary lifestyle, which is a risk factor for type 2 diabetes.

Type 1 diabetes

People living with type 1 diabetes may also be at higher risk of developing RA and vice versa.

The Global Healthy Living Foundation, a nonprofit organization, explains that type 1 diabetes is an autoimmune disorder in which the immune system mistakenly attacks insulin-producing cells. It notes that a person living with one autoimmune disorder has an increased chance of developing a second one at some point in their lifetime.

People living with RA may have an increased risk of developing type 2 diabetes. Researchers have found that people living with RA are 23% more likely to develop type 2 diabetes compared with the general population.

In a 2020 review, researchers noted that RA can negatively affect a person’s insulin resistance, which can cause the body to develop more fat. They also reported that many people with RA who develop type 2 diabetes also have other risk factors, including obesity.

People living with RA may be more likely to develop type 1 diabetes, as both conditions are autoimmune disorders. A person who has an autoimmune condition is more likely to develop another one during their lifetime.

The Arthritis Foundation suggests that people over the age of 45 years get screenings for diabetes every 3 years, noting that this is particularly important for those living with RA.

Learn more about risk factors for type 2 diabetes.

People living with type 1 diabetes have a higher risk of developing RA. In part, this may be due to both conditions being autoimmune disorders. There also may be a genetic link between the two conditions — research has shown that the gene PTPN22 is linked to both conditions.

Some researchers believe that the inflammation associated with type 2 diabetes triggers RA in people who are genetically predisposed. A 2014 study in Taiwan supports this theory, finding that living with type 2 diabetes increases the risk of RA in females.

It is unclear whether type 1 or 2 diabetes could make RA symptoms worse. However, similar lifestyle changes can help both conditions, including:

The Centers for Disease Control and Prevention (CDC) states that people living with diabetes may have some combination of the following symptoms:

People living with type 1 diabetes generally develop more severe symptoms more quickly than people living with type 2 diabetes. A person with type 1 diabetes may also notice nausea, stomach pain, and vomiting.

It is vital that a person with RA has regular screenings for diabetes because the symptoms of type 2 diabetes are not always noticeable.

Learn more about the early warning signs of type 2 diabetes here.

A person can lower their risk of developing type 2 diabetes. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) advises taking the following steps to prevent type 2 diabetes:

  • reaching or maintaining a moderate weight
  • engaging in 30 minutes of exercise on at least 5 days of the week where possible
  • eating nutritious foods and avoiding sweetened beverages and overly fatty foods

According to the CDC, researchers do not currently know how to prevent a person from developing type 1 diabetes.

Learn more about how to prevent type 2 diabetes here.

Doctors can help create an effective treatment plan for a person living with RA, diabetes, or both.

A doctor can recommend a combination of medications alongside self-care strategies to slow the progression of RA and prevent joint damage. The CDC says that possible strategies for people living with RA include:

  • learning safe and effective ways to manage pain, exercise regularly, and make any necessary lifestyle adjustments
  • maintaining a moderate weight
  • getting regular, safe exercise
  • seeking regular care from a doctor and taking all arthritis medications according to the prescriptions
  • avoiding smoking

Learn some tips for dealing with rheumatoid arthritis flare-ups here.

The Arthritis Foundation notes that treating a person living with RA and type 2 diabetes is not much different than treating a person living with RA alone. One of the most important aspects for a person living with both conditions is to get regular exercise to help prevent heart disease.

A doctor may recommend a combination of medications and lifestyle adjustments to manage diabetes. In some cases, a person may find that diet and exercise modifications are enough to control their blood sugar.

If a person cannot control their blood sugar with diet and exercise alone, a doctor may recommend medication. They may recommend drugs to help the body process sugar or prescribe insulin.

Read a review of therapies and lifestyle changes for diabetes here.

RA and diabetes share some similar features, and a person with one condition may have an increased risk of the other.

People living with type 1 diabetes may have an increased risk of RA, and vice versa, due to the connection between autoimmune disorders and genetics. The inflammation associated with type 2 diabetes may put individuals with this form of diabetes at higher risk of RA. RA can make a person more likely to develop type 2 diabetes by affecting their insulin resistance.

A person living with RA should get regular screenings and watch for warning signs of diabetes. A person with a diagnosis of type 2 diabetes should follow their doctor’s treatment advice.