Does Gout Cause Diabetes?
Could you explain to me the connection between gout and diabetes? I heard that a new study showed that one causes the other. If you have gout, how would you avoid diabetes?
Andrew Weil, M.D. | January 27, 2015
A study published in October, 2014, did find a link between gout and type 2 diabetes – specifically, it showed that having gout appears to increase the risk of developing diabetes, particularly among women. However, while both conditions have several risk factors in common, the connection between them isn’t clear. The study found an association, but it didn’t prove cause and effect.
Researchers from the U.S. and the U.K. followed more than 35,000 gout patients in Great Britain, gathering data on both women (9,693) and men (25,646). The investigators also compared the data from the gout patients with information on just over 137,000 people who didn’t have gout.
After comparing all the medical facts, the research team found that women who had gout were 71 percent more likely to develop diabetes than a comparable group of women who didn’t have gout. Among men, those with gout had a 22 percent increased risk.
Gout is an inherited metabolic disorder that can cause a type of arthritis. It usually affects the big toe but can also occur in other joints including the ankles, heels, knees, wrists, fingers and elbows. Attacks can be extremely painful and are worsened by being on your feet. The hallmark of gout is elevated blood levels of uric acid, a breakdown product of protein metabolism.
In news reports, the study’s lead researcher, Hyon Choi, M.D. of Boston’s Massachusetts General Hospital, suggested that ongoing low levels of inflammation due to gout might increase the risk of diabetes. The risk factors the two diseases have in common are high cholesterol, high blood pressure and obesity. Gout is also associated with metabolic syndrome, and an increased risk of major cardiovascular events and premature death, the researchers noted.
Excess alcohol consumption and exposure to lead in the environment also increase the risk of gout in genetically susceptible individuals. Other risk factors include dehydration and acid conditions of the blood that can result from serious infections, surgery or ketogenic weight loss diets (such as the Atkins diet).
Physicians often prescribe non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen to address the inflammation and pain gout causes. Corticosteriods administered via pills or injections can have a similar affect. There are also drugs to lower uric acid levels; the best known is allopurinol (Zyloprim). All of these measures should be used only as a last resort, as they can cause significant side effects.
Like so many diseases, gout is likely an artifact of inflammation and lifestyle. Your first line of defense should be following an anti-inflammatory diet and making changes in lifestyle. Here are more of my recommendations for managing gout.
Andrew Weil, M.D.
Hyon Choi, et al “Independent impact of gout on the risk of diabetes mellitus among women and men: a population-based, BMI-matched cohort study” Annals of Rheumatic Diseases 2014; DOI: 10.1136/annrheumdis-2014-205827.