European League Against Rheumatism (EULAR) had provided different sets of recommendations for the management of cardiovascular risk in inflammatory arthritis patients, but inspite of that cardiometabolic comorbidity, such as type 2 diabetes (T2D), remains still underdiagnosed and undertreated in patients affected by rheumatoid arthritis (RA) .
.A single centre, prospective study was conducted in order to better investigate the occurrence of T2D during the course of 1 year of follow-up. In addition to this the researchers evaluated the role of both traditional cardiovascular and RA-specific related risk factors to predict the occurrence of new T2D. The researchers presented the results of their investigation into the relationship between cardiovascular risk factors, rheumatoid arthritis risk factors, and new-onset type 2 diabetes in a recent PLoS ONE article. It was found that there is a significant increase in the short-term risk of type 2 diabetes mellitus in patients who have rheumatoid arthritis .
The authors conducted a longitudinal observational cohort study to determine the risk of type 2 diabetes in patients with rheumatoid arthritis; 439 consecutive patients were included .They observed that 7.1% of the patients (31/439) developed T2D, after 12 month of prospective follow-up. The regression analysis showed that the presence of high blood pressure, the impaired fasting glucose (IFG) at the first observation and the poor EULAR-DAS28 response, after 12 months of follow–up, were significantly associated with an increased likelihood of being classified as T2D. Similarly, we observed that 7.7% of our patients (34/439) showed IFG after 12 months of prospective follow-up. The regression analysis showed that the presence of high blood pressure and the poor EULAR-DAS28 response after 12 months of follow-up, were significantly associated with an increased likelihood of showing IFG.
It wes concluded that the study supports the hypothesis of a significant short-term risk of T2D in RA patients and of a close associations between uncontrolled disease activity and glucose metabolism derangement. Further multicentre, randomised-controlled studies are surely needed in order to elucidate these findings and to better ascertain the possible contribution of different therapeutic regimens to reduce this risk.
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Dr. Kamal Kant Kohli
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