Gout and diabetes: What is the link between the two

Gout is a form of inflammatory arthritis that usually affects one joint at a time. It is generally the big toe joint, and it is very painful. It is often associated with diabetes, a long-term medical condition in which the blood glucose levels shoot up. The two are different health conditions, but they share a close relationship. It is not just that there is no cure for gout or diabetes. The link between the two goes deeper. You may be wondering if gout can lead to diabetes and vice-versa. Read on to know the connection between gout and diabetes.

What is gout?

It is a complex form of inflammatory arthritis caused by the accumulation of uric acid crystals in the joints, says internal medicine expert Dr Kundan Khamkar. Uric acid, which is a waste product, gets formed when our body breaks down purines. They are naturally occurring substances that can be found in some of the foods and also produced by our body. When there is an excess uric acid in the blood, it can lead to the formation of pointed, needle-like crystals in the joints, triggering an inflammatory response. This leads to sudden and severe pain, swelling, redness, and warmth in the affected joint or joints. Gout mostly affects the big toe, but it can also occur in other joints such as the knees, ankles, wrists, elbows, and fingers.

What are the causes of gout?

Right from are dietary factors to obesity, there are many causes of gout.

• Foods high in purines, such as red meat, seafood, and alcohol, can contribute to elevated uric acid levels in the blood, increasing the risk of gout attacks.
• Genetic factors can influence how the body processes uric acid, making some people more prone to developing gout.
• Obesity is also a significant risk factor for gout, as excess body weight can lead to insulin resistance and higher levels of uric acid.
• Certain medications, such as diuretics that is used to treat hypertension, can raise uric acid levels.
• Medical conditions such as hypertension, kidney disease, and metabolic syndrome are associated with an increased risk of gout.

What are the symptoms of gout?

The symptoms typically include sudden and intense joint pain, often described as excruciating. The pain usually begins suddenly, often at night, and can be so severe that even the weight of a bedsheet can cause discomfort, says the expert. The affected joint becomes swollen, red, and warm to the touch. The pain and inflammation can make it difficult to move the joint, and even the slightest touch or movement can exacerbate the discomfort.

Gout attacks can last for a few days to several weeks, with the pain gradually going away as the inflammation resolves. Without treatment, gout attacks may recur and can lead to joint damage and deformity over time. Treatment for gout typically involves a combination of medications to manage pain and inflammation during acute attacks and prevent future flare-ups, as well as lifestyle modifications to reduce uric acid levels in the blood. Medications commonly used to treat gout include nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, corticosteroids, and xanthine oxidase inhibitors (e.g., allopurinol, febuxostat) to lower uric acid levels, says the expert.

Gout and diabetes

Gout may be associated with a higher risk of diabetes, especially in women, according to a 2016 study published in the Annals of the Rheumatic Diseases journal.

Gout and diabetes share common risk factors such as obesity and poor dietary choices, but they are not directly linked in terms of causation, says Dr Khamkar. However, people with diabetes may have an increased risk of developing gout due to factors associated with diabetes, such as insulin resistance and elevated levels of uric acid in the blood. Insulin resistance, a hallmark of type 2 diabetes, can lead to higher levels of insulin circulating in the bloodstream, which in turn can reduce the excretion of uric acid by the kidneys, contributing to hyperuricemia. As per the Centers for Disease Control and Prevention, people with diabetes tend to have an increased risk of developing gout. They often have hyperuricemia, which is the main cause of gout.

Obesity, which is strongly associated with both type 2 diabetes and gout, can further exacerbate the risk by promoting insulin resistance and increasing the production of uric acid.

How to manage gout and diabetes?

Managing diabetes and gout involves adopting a comprehensive approach that addresses the underlying factors contributing to each condition. This includes:

• Having a balanced diet low in purines and sugars
• Regular exercise
• Weight management
• Monitoring blood sugar levels
• Taking prescribed medications as directed by the doctor.

It is essential to seek medical attention if you experience symptoms of gout, such as sudden and severe joint pain, especially if accompanied by fever or chills. Also, people with diabetes should undergo regular check-ups and monitoring to assess blood sugar levels, manage diabetes-related complications, and ensure optimal health outcomes.

While gout and diabetes are distinct medical conditions with different underlying mechanisms, they can coexist in people who have multiple risk factors, such as obesity, and insulin resistance.