This post was originally published on this site
Gout and type 2 diabetes often go hand in hand, and people with both conditions need to learn how to manage one without worsening the other.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295b51746d-c071-44e0-ba71-a76fbd543e47 These two health issues, which share some potential causes and may be related, are each treated with a combination of medication and lifestyle changes.e60dc2a1-f33c-4a05-9b50-8e3e8e5976297421d9f3-3f13-44de-8d91-5b045a923749 A healthcare provider can help you develop a plan to use dietary choices and medications to reduce the symptoms and complications of each condition.
Causes of Gout Causes of Gout Gout is an inflammatory form of arthritis that’s noted for painful flare-ups in the joints, most commonly at the base of the big toe. Pain from gout comes and goes but can grow worse if left untreated. Gout develops when there’s a buildup of uric acid in the body. When that happens, urate crystals can form in the joints, which leads to inflammation and flare-ups of intense pain.e60dc2a1-f33c-4a05-9b50-8e3e8e597629226a3855-f549-4b32-9e1e-b50e731d19f5 This buildup in the bloodstream is called hyperuricemia.e60dc2a1-f33c-4a05-9b50-8e3e8e59762918916dc9-07ff-42c0-a5a5-cd7b86dc29e9 “Hyperuricemia, characterized by elevated uric acid levels in the blood, is commonly associated with gout,” says Farzaneh Daghigh, PhD , a professor of biochemistry at Philadelphia College of Osteopathic Medicine. Several factors can lead to high uric acid levels, many of which are also risk factors for diabetes:e60dc2a1-f33c-4a05-9b50-8e3e8e5976297c02bd65-6899-47ea-a639-6ee1bca0770f Too much alcohol Consumption of red meat Consumption of too much sugar Genetics Obesity Metabolic syndrome Diuretics High blood pressure
The Connection Between Diabetes and Gout The Connection Between Diabetes and Gout Diabetes and gout have a bidirectional relationship, which means that each condition influences the other.e60dc2a1-f33c-4a05-9b50-8e3e8e5976298083e61e-9705-42f3-9604-051dada35d07 “The two conditions have a common upstream risk factor, which is obesity,” says Stephen P. Juraschek, MD, PhD , a gout researcher and an associate professor of medicine at Beth Israel Deaconess Medical Center in Boston. “We know that a higher BMI and obesity is associated with diabetes and is strongly associated with gout.” Additionally, metabolic syndrome is also common with these two conditions.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299ce40a4f-1641-4ef4-b798-4b952bf35fda Metabolic syndrome is a group of warning signs, including high blood pressure, abdominal obesity, hyperglycemia , and unhealthy cholesterol levels, that collectively indicate a higher risk for life-threatening illnesses. According to gout researcher Youssef M. Roman, PharmD, PhD , an associate professor of pharmacy practice and administrative sciences at Idaho State University in Pocatello, gout may also be related to insulin resistance.e60dc2a1-f33c-4a05-9b50-8e3e8e5976298083e61e-9705-42f3-9604-051dada35d07 Higher amounts of insulin in your blood caused by insulin resistance is called hyperinsulinemia.e60dc2a1-f33c-4a05-9b50-8e3e8e59762987787f82-e1f0-478e-ac4a-be1edcfc497f “Hyperinsulinemia, a hallmark of type 2 diabetes, can have major effects on the expression of multiple genes responsible for uric acid disposition,” says Dr. Roman. Despite the obvious overlap, the relationship between gout and diabetes isn’t completely understood. Roman says it can be difficult to tell exactly which one leads to or causes the other. One study suggested diabetes could be associated with increased serum urate levels.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e9dfbe4c-eb55-4be9-8edd-58772e45f87e Another study found that developing diabetes at a younger age was associated with early gout development.e60dc2a1-f33c-4a05-9b50-8e3e8e5976290dddf9fc-dc6c-4e98-9d89-527fe71d68ff To confuse things further, other research suggests that diabetes may protect against gout.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c579aab6-461d-43ba-8074-9a6601904111 “Studies that have looked at diabetes duration over time have shown that gout risk trends downward a little bit and the mechanisms for this are not entirely clear,” says Dr. Juraschek. Juraschek says there is bidirectionality between the two because of metabolic syndrome, “but I’m not sure I would say that uric acid is explicitly causing diabetes or diabetes is acting directly on gout.” If you do have both conditions, talk to your doctor about harmonizing your treatments so you can treat each condition without making the other worse.
How Diet Impacts Gout and Diabetes Diet Food choices are a central part of diabetes management — primarily limiting your intake of refined carbs and sugar and focusing on whole and minimally processed foods. But even though gout was once known as the “king’s disease” because only people of means could afford to consume the rich, fatty foods associated with it, the condition is only partially related to dietary choices.e60dc2a1-f33c-4a05-9b50-8e3e8e5976297a971785-5be0-47f1-8aaa-c0b761eca031 “Gout has a strong genetic basis, which explains the family history of gout,” says Roman. “Although you can manage your diet, you can lower your alcohol consumption, you can do all the things … relying on that to cure or manage gout is not sufficient.” Despite the genetic link, diet does play a central role in managing the disease. It is generally recommended that people with gout avoid these types of foods.e60dc2a1-f33c-4a05-9b50-8e3e8e597629803fa4ef-be9f-4836-ae05-e8d7fbe7788e High-purine foods : Purines are organic compounds that are essential building blocks of DNA and RNA. When the body breaks down purines, it produces uric acid.e60dc2a1-f33c-4a05-9b50-8e3e8e597629cfc3dcb1-9914-4a08-8013-750e3b1c9655 The foods with the highest concentration of purines include beef, chicken, duck, pork and ham, and shellfish.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d9bc561d-5176-4d70-82f5-95fb8c1e45f6 Alcohol: Alcohol contains purines, too. Limiting or avoiding consumption of beer, wine, and spirits is recommended for patients with gout, regardless of whether or not you’re experiencing a flare. High-fructose corn syrup: This is a concentrated form of sugar found in many packaged food products, such as cereals, candy, baked goods, fast food, and beverages. Many of the foods that people with gout should avoid are the same dietary no-nos for diabetes. Fish, however, because it’s typically lean and high in protein, is a good dietary choice for people with blood sugar issues. Dr. Daghigh says it doesn’t necessarily have to be totally eliminated if you also have gout. “Seafood provides essential nutrients, and lower-purine options such as salmon or shrimp may be eaten in moderation,” Daghigh says. Roman is a fan of the DASH diet for people who have both health conditions. It limits sodium, sweets, and fatty meats while emphasizing vegetables, whole grains, and foods rich in protein and fiber. He also says it’s important for people with gout to know which foods are most likely to trigger their gout flare-ups.
Treating Gout and Diabetes Treating Gout and Diabetes Beyond limiting the foods you eat, treating gout also involves taking medications. For short-term relief from flares, doctors can prescribe:e60dc2a1-f33c-4a05-9b50-8e3e8e59762969280b82-6d77-4bdb-9959-7c08e400507a Nonsteroidal anti-inflammatory drugs (NSAIDs), either over the counter or prescription Colchicine, an anti-inflammatory prescription drug that treats and prevents gout attacks Corticosteroids , which are powerful anti-inflammatories that can be taken in a pill or as an injection in the affected joint People with diabetes may need to be especially careful about using steroids , as they can increase blood glucose levels. When you’re also managing diabetes, talk to your doctor about this potential gout treatment option, as it may require you to enhance your blood sugar monitoring or temporarily increase your doses of glucose-lowering medications.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c4f7b274-f229-46a1-afc8-196c70f21431 For long-term protection against gout attacks and complications, doctors can also prescribe medications that block uric acid production, such as allopurinol, febuxostat, or colchicine. Roman says allopurinol is a common starting treatment, but if it’s not effective, your doctor may switch you to febuxostat. All these drugs are considered safe for those with diabetes.e60dc2a1-f33c-4a05-9b50-8e3e8e59762958147c60-17d3-4cb7-b225-53df0b6ed49e Beyond limiting certain foods, there are other lifestyle tweaks people with gout should make. Weight loss, one of the most important goals of type 2 diabetes treatment,e60dc2a1-f33c-4a05-9b50-8e3e8e5976290ef25161-8b0a-4d7d-97a8-704d8a91f4e7 is also recommended as a potential therapy for gout in people who are overweight or obese.e60dc2a1-f33c-4a05-9b50-8e3e8e5976290995c393-0ca5-4e93-b32d-361bfd7b154c While exercise is a helpful way to do that, make sure you start slowly and don’t push yourself too hard. Overdoing it when you have a flare could lead to more inflammation and pain.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b9253bfd-15a1-469f-b42f-9ca4a728be33 Managing gout when you have diabetes will require ongoing conversations with medical professionals to find what works for your situation. “It’s essential to consult a healthcare professional to determine the most appropriate course of action, diet, lifestyle modification, and treatment plan based on individual symptoms and health conditions,” says Daghigh.
The Takeaway Gout and type 2 diabetes often occur together and share risk factors such as obesity, excess sugar consumption, and metabolic syndrome. Avoid certain foods and drinks if you have gout, particularly foods high in purines like meat, seafood, and alcohol. It may take a little extra work to find a sustainable diet that helps both diabetes and gout, but many of the same foods that people with gout should avoid are also not recommended for those who have diabetes. Work with your healthcare providers to find effective medications and food choices that keep blood sugar levels in a healthy zone and prevent gout flare-ups as well.
Resources We Trust Cleveland Clinic: GoutMayo Clinic: Gout Diet: What’s Allowed, What’s NotCreakyJoints: Gout and Type 2 Diabetes: Why You’re at Increased Risk Arthritis Foundation: Managing a Gout FlareAmerican Diabetes Association: Eating Well & Managing Diabetes
