Rheumatoid Arthritis Tied to 23% Increase in Risk of New Diabetes

Adrian Heald, MD

New data from a study presented at the European Association for the Study of Diabetes (EASD) 2020 annual meeting suggests patients with rheumatoid arthritis were at a nearly 25% increased risk of developing diabetes compared to the general population.

The study, which was conducted by researchers from the University of Manchester, sheds further light on the potential impact of systemic inflammation associated with the common rheumatic disease.

"This finding supports the notion that inflammatory pathways are involved in the pathogenesis of diabetes,” said study investigators.

Led by Adrian Heald, MD, an honorary research fellow, the team of investigators from the University of Manchester sought to evaluate potential associations between inflammatory diseases and the onset of type 2 diabetes. With this in mind, they designed their study as a comprehensive search of the Medline, Embase, and Web of Science databases from inception through March 10, 2020.

Searching for studies comparing the risk of diabetes mellitus incidence in people with rheumatoid arthritis versus those in the general population, investigators identified a total of 3669 articles for potential inclusion in their analysis. After the application of inclusion criteria and abstracting screening, investigators identified 5 journal articles and 2 conference abstracts to be included in their final analysis.

From these studies, investigators obtained data related to 1,639,854 participants. Investigators noted most studies were population-based but 1 of the studies included was hospital-based. Additionally, investigators noted heterogeneity was observed in an I2 test (I2=96%; P <.01).

Upon analysis of these studies, investigators found rheumatoid arthritis was associated with a 23% increase in risk of diabetes mellitus incidence (pooled RR, 1.23; 95% CI, 1.07-1.40). In a sensitivity analysis, investigators found exclusion of the hospital-based study did not materially change the result (pooled RR, 1.23; 95% CI, 1.06-1.42).

“We suggest that more intensive screening and management of diabetes risk factors should be considered in people with rheumatoid arthritis. Agents that reduce systemic inflammatory marker levels may have a role in preventing type 2 diabetes. This may involve focusing on more than one pathway at a time,” investigators added.

This study, “The relation between rheumatoid arthritis and diabetes incidence: a systematic review and meta-analysis,” was presented at EASD 2020.