Psoriatic arthritis (PsA) is a painful, chronic condition that causes inflammation of the joints and entheses (where the tendons and ligaments attach to bone).1 PsA is an autoimmune disease that usually occurs in people who already have psoriasis but can sometimes affect people who don't.
If you have PsA, you're also more likely to have type 2 diabetes.2 This is the most common type of diabetes and is caused by blood sugar (glucose) being too high, often because your body doesn’t use insulin well.3
Read on for more information about the connection between PsA and diabetes and ways to manage both conditions.
The Link Between Psoriatic Arthritis and Diabetes
The exact reason why people with PsA are more likely to have type 2 diabetes is not yet known, but several factors may be at play. One possibility has to do with the immune system not functioning properly. Immune system proteins known as cytokines can trigger higher levels of inflammation in people with PsA.
This, in turn, leads to elevated blood sugar levels and insulin resistance (when cells don’t absorb blood sugar well and need more insulin, causing the pancreas to produce more).2
The medications used to treat PsA may also contribute to the development of type 2 diabetes. Some systemic therapies (those that target the entire body) like corticosteroids, for example, can cause insulin resistance.2
More research is needed to examine the underlying connections between PsA and type 2 diabetes.
Prevalence of Comorbidities
Between 2.4% and 14.8% of the general population will develop type 2 diabetes.2
In those with PsA, however, the prevalence of type 2 diabetes is between 6.1% and 20.2%.2
The Role of Inflammation in Both Conditions
Inflammation is a significant factor in both PsA and type 2 diabetes. PsA often presents with inflammation in the joints and connective tissue; over time, it can cause permanent joint damage and/or long-term disability.2
People with type 2 diabetes often have chronic inflammation that isn't acute but contributes to insulin resistance.4 Chronic inflammation also raises your risk of developing type 2 diabetes in the first place.5
Identifying the Symptoms
Being aware of the symptoms of PsA can help you monitor how it's progressing. And knowing the warning signs of type 2 diabetes will allow you to get medical attention as early as possible, thus improving your outcome.
Symptoms of PsA can include:1
- Scaly or inflamed patches of skin that are characteristic of psoriasis
- Stiffness, pain, tenderness, and/or swelling in one or more joints
- Fatigue
- Painful swelling of an entire finger or toe
- Nail changes
- Eye inflammation
- Inflammatory bowel disease (IBD, including Crohn's disease and ulcerative colitis)
Symptoms of type 2 diabetes can include:3
- Increased thirst and hunger
- More frequent urination
- Fatigue
- Blurred vision
- Sores that take a long time to heal
- Tingling or numbness in the feet or hands
Type 2 diabetes can develop over years, so you may not notice the symptoms until the disease has progressed and you're more at risk of having serious health complications.
Lifestyle Changes That Can Help
While lifestyle changes won't cure PsA or diabetes, they can help minimize your symptoms and make you feel healthier overall.
Eat Nutrient-Dense Foods
A balanced diet that includes foods that help reduce inflammation is a smart strategy for managing both PsA and type 2 diabetes. Fatty fish with omega-3 fatty acids such as salmon and tuna have been found to help relieve inflammation while also lowering the risk of heart disease.6 Lean proteins, colorful vegetables, nuts, and olive oil can all help as well. On the contrary, a diet high in sugar could make inflammation worse.7
Exercise Regularly
Regular physical activity helps with strength and mobility and can even ease PsA-related pain and fatigue.8 It also helps your body's cells become more sensitive to insulin.9 Walking with a friend is a great start, especially if you aren’t used to physical activity. Before starting an exercise program, check with your healthcare provider to confirm which activities are safe and appropriate for you.
Maintain a Healthy Weight
Obesity is one of the more common comorbidities (conditions that also occur) with PsA.10 It's also a risk factor for type 2 diabetes and insulin resistance.11 Obesity can contribute to inflammation, because adipocytes (fat cells) release pro-inflammatory chemicals.10
Extra pounds also put more stress on the joints.10 If you find it challenging to maintain a healthy weight, talk with your healthcare provider, who can help create diet and exercise plans for you.
Reduce Stress
Stress plays a role in both PsA12 and type 2 diabetes.13 Not only can it cause inflammation, it can also change the way your body metabolizes glucose. Over time, chronic stress can lead to high blood sugar14 and a weakened immune system.15 Techniques for managing stress include:
- Talking to a therapist
- Joining a support group
- Exercise
- Deep breathing
- Progressive muscle relaxation
When to See a Healthcare Provider
If you have symptoms of either PsA or type 2 diabetes, call your healthcare provider. They'll give you an accurate diagnosis and come up with a treatment plan to help manage the symptoms so you can start to feel better.
Summary
PsA puts you at greater risk of developing type 2 diabetes. While the exact connection is still unknown, researchers are exploring several possibilities, including the role that inflammation might play. Lifestyle changes such as staying active and reducing stress can help manage your symptoms and improve your overall health.
A Word From Verywell
Living with more than one chronic condition can seem overwhelming, but there are many steps you can take to feel better. If you’re not sure where to start, ask your healthcare provider. Your provider can connect you with the resources you need, whether that’s a counselor, a personal trainer, a dietitian, or a support group.
https://www.jpost.com/health-and-wellness/article-710473
