Diabetes, Gout Have Complex Relationship

The connection between diabetes and gout is more complicated than thought.

Individuals with type 2 diabetes are at increased risk of developing gout, but not because they have diabetes.

In a retrospective cohort study using the UK Clinical Practice Research Datalink GOLD database, researchers compared 221,117 people with type 2 diabetes taking either insulin or a non-insulin diabetic drug with an equal number of randomly selected healthy people in the same database. The control group was matched by age, sex, and the medical practice where they received treatment.

When they estimated the risk of developing gout in people with diabetes compared with the control group, they found an increased risk for gout that was stronger in women than in men.

However, when the researchers adjusted for BMI, renal function, hypertension, renal transplantation, and certain drugs, they found the risk not only disappeared, but in men it was actually reversed. Those who were otherwise healthy but had a higher HbA1c actually had a lower risk for developing gout.

It turns out that the co-morbidities like hypertension and impaired renal function that frequently accompany type 2 diabetes are to blame for the higher risk.

“Healthcare professionals treating individuals with diabetes should be knowledgeable about diagnosis and treatment of gout, especially in patients with well-controlled diabetes,” write Frank de Vries, PhD, and colleagues. The researchers come from the Maastricht University Medical Centre and Utrecht University, in The Netherlands and the University of Southampton, in the United Kingdom. The study appeared in the August 2015 issue of Medicine.