RA Treatment May Reduce Diabetes Risk

According to multiple studies reviewed in April’s Arthritis Care & Research, prolonged use of tumor necrosis factor α (TNFα) in rheumatoid arthritis (RA) patients could potentially decrease the possibility of acquiring insulin resistance (IR).

The connection between molecular markers of inflammation, alterations in body composition, and IR was examined by Mary Chester Wasko, M.D., and colleagues from the University of Pittsburgh School of Nursing.

During their investigation, they uncovered a series of studies published between the years 1949 and 2010 which discussed IR and body habitus in patients with RA; they also assessed the role of TNFα in the pathophysiology of type 2 diabetes mellitus and RA, and the effect of antirheumatic drugs on glycemic control.

"Patients with chronic inflammatory diseases such as RA are at higher risk of developing impaired glucose metabolism that may eventually progress to type 2 diabetes mellitus," the authors said in the review. "Patients with RA in whom disease activity is effectively controlled may experience the additional clinical benefit of improved insulin sensitivity."

The researchers discovered that RA patients possessed attributes which increased their risk for IR and type 2 diabetes, as well as cardiovascular disease (CVD). In comparison to the general population, however, there was no clear increase of prevalence of type 2 diabetes once the TNFα antagonists took effect, which also rapidly decreased RA-related inflammation as well as supported evidence that the drug may improve insulin sensitivity if used for an elongated period of time.

On the whole, the danger of developing type 2 diabetes and CVD in patients with RA may be decreased through treatment-related changes.

All the study authors disclosed financial ties to the pharmaceutical industry. Two authors disclosed a financial relationship with Centocor Ortho Biotech Inc., which supported the study.