类风湿关节炎and Diabetes

RA是一种慢性炎症状况，免疫系统启动过驱动，攻击关节。这种痛苦的经历会影响关节的衬里，从而导致肿胀，随着时间的流逝，这会导致关节畸形和骨侵蚀。使RA更具挑战性的原因是，炎症会对从肺和心脏到皮肤和眼睛的身体其他部位造成严重破坏。但是，如果您有RA，那么您远非独自一人，这种病情占有130万美国人的控制，在女性中更为常见。

Surely, you’ve heard the terms type 1 and type 2 diabetes. Type 1, sometimes called juvenile diabetes is a chronic condition causing the pancreas to not create enough insulin. It typically begins in childhood and symptoms can look like fatigue, frequent urination, and even blurry vision. Type 2 diabetes means your body is resistant to insulin (the hormone that helps store sugar). If you can’t store the sugar properly it ends up in your blood and over time that can cause a lot of problems. Symptoms of this condition are like those you see with type 1 and include frequent urination, fatigue, hunger, and thirst.

发表的评论Cardiovascular Endocrinology & Metabolismfound that people with RA are 23% more likely than the general population to have type 2 diabetes because RA decreases the body's response to insulin (similar to insulin resistance), causing it to produce more fat. There’s also a link between RA and type 1: “Type 1 diabetes and rheumatoid arthritis are both autoimmune diseases. Having one autoimmune disease can increase the risk of having another, and prior studies have found a link between type 1 diabetes and rheumatoid arthritis,” says Farah Khan M.D., a physician at the Endocrine and Diabetes Care Center at the University of Washington School of Medicine in Seattle, WA.

Understanding exactly how diabetes can develop in a body that is also fighting RA is a bit complex, but Dr. Khan breaks it down. “RA is an inflammatory disease process. Systemic inflammation leads to increased physiologic stress which can then contribute to the development of high blood sugars and potentially also diabetes over time,” explains Dr. Khan. “Additionally, patients with RA often require corticosteroids (steroid hormones) for treatment, which can also contribute to the development of diabetes over time.” For this reason, if you have RA, diabetes prevention should be included in your care plan.

在Annals of Rheumatic Diseases发现某人患糖尿病和RA的可能性与他们的疾病活动程度有关（基本上是您的症状是多么受控或不受控制）。随着时间的流逝，患有高RA病活动的人更有可能患糖尿病，这可能是由于血液中的细胞因子和趋化因子（炎症度量）较高，这也会增加糖尿病的风险。“患有RA的人的疾病活动有很多炎症（导致）糖尿病的风险更高，”宾夕法尼亚大学宾夕法尼亚大学风湿病学和流行病学副教授Joshua F. Baker，医学博士Joshua F. Baker，M.D。宾夕法尼亚州费城。

除了炎症和疾病活动外，您还应该关注RA和糖尿病的另一个因素。贝克博士的研究发现，当您已经患有RA是肥胖症时，患糖尿病的最大危险因素。这项研究检查了一千多人被医生诊断出患有RA的人，并发现患有高体重指数（BMI）的人患糖尿病的风险更高。这也与普通人群进行跟踪。仅患有肥胖症（或不带RA）会使您患糖尿病的风险更高，这会使疾病恶化更快，per Cleveland Clinic.

如果我们没有指出一些研究实际上质疑RA对一日患糖尿病的影响，我们将被解雇。一项发表在期刊上的研究关节炎护理与研究，发现RA的参与者比没有RA的参与者患有2型糖尿病。贝克博士承认这项研究，但虽然科学可能无法完全解决炎症是否有助于胰岛素抵抗，但需要进行其他研究。但是，对于RA的人来说，定期筛查糖尿病并采用健康的生活方式来降低风险很重要。

In many cases, there aren’t a lot of symptoms when it comes to developing diabetes with RA. Early symptoms of diabetes can be weight loss and excessive urination from your body working to eliminate sugar. But it’s important not to wait until you reach this point. Experts say undergoing a diabetes screening with your doctor is the best course of action, but you need to request it. Not all doctors will automatically offer routine diabetes screening, so if you are at high risk for diabetes (like it runs in your family or you have obesity) ask your doctor how often you should be screened.

这个话题很复杂，可能会感到压倒性，但是贝克博士说，在患有RA的同时减轻糖尿病的关键是减肥（另外，losing pounds is also good for your joints). He admits this is easier said than done and that physicians aren't the best at spelling out practical ways of dropping the weight. Eating foods that fall within theMediterranean diet，其中包括全谷物，瘦蛋白，蔬菜和一些橄榄油，是一个不错的起点。贝克说：“即使您没有减肥，只要饮食良好，锻炼身体并保持肌肉强壮也有助于管理这些疾病。”