Diabetes and gout are two separate health conditions that may either precede each other or occur at the same time. Both these conditions can pose serious health risks if not addressed at the earliest.
“Elevated uric acid levels in the blood lead to hyperuricemia. As a result, the excess uric acid crystallises and deposits in the joints, causing gout, which is characterised by pain and inflammation,” explains Bengaluru-based nephrologist, Dr Garima Aggarwal.
Diabetes, on the other hand, is a metabolic disorder where an individual with unmanaged blood sugar levels may face complications like increased blood pressure, excessive weight gain and high lipid levels.
Both conditions are often associated with the same comorbidities. The presence of one condition often increases the risk of the other, making it vital for people with diabetes to monitor their uric acid levels and vice versa.
Hyperuricemia and type 2 diabetes
According to Dr S Satish Kumar, HOD and lead consultant, endocrinology, diabetology & bariatric medicine, Aster RV Hospital, Bengaluru, elevated uric acid levels (in overweight or obese people) are associated with a poor history of type 2 diabetes management. Research indicates that people with hyperuricemia or gout are at high risk of developing diabetes, he adds.
According to a study published in The American Journal of Medicine, individuals with elevated serum uric acid levels (including younger adults) were found to be at a higher risk of developing type 2 diabetes, independent of other risk factors.
Dr Aggarwal, who receives several cases of hyperuricemia and gout, says that diabetes and gout can occur in people who lead similar lifestyles. However, genetic factors may also contribute to the two conditions, she adds, emphasising the need for further research on this matter.
Gout and diabetes: Risk factors for other complications
Dr Banshi Saboo, an Ahmedabad-based diabetologist and chair-elect (2023-24) for the International Diabetes Federation (IDF), says that a high uric acid level is a risk factor for endothelial dysfunction (narrowing of blood vessels). “This means that people with hyperuricemia are at higher risk of getting a heart attack and other diabetic comorbidities,” he adds.
Dr Aggarwal explains that while some people with diabetes who consult her also present with hyperuricemia, others tend to have renal dysfunctions, which are significant risk factors for hyperuricemia and gout.
She recalls the case of a 42-year-old man who had severe gout pain for 10 years. He had a family history of gout and developed diabetes two years ago. A check-up later revealed he had some amount of kidney damage as well due to excessive intake of painkillers (for gout pain) over the years.
Besides medication, Dr Aggarwal asked him to make certain lifestyle changes (like a healthy diet and an active lifestyle), which have helped him balance and manage the two conditions (along with the kidney damage).
Dr Saboo says having gout along with diabetes can be extremely painful, as those with diabetes can also develop comorbidities like diabetic myopathy (characterised by muscle pain and weakness), diabetic osteoarthropathy (characterised by joint pain, especially in the foot) and diabetic neuropathy (characterised by pain and numbness in the feet along with cardiovascular complications)
Common triggers for gout and diabetes
According to experts, some common factors that can trigger gout and diabetes include:
- Obesity: According to Dr Aggarwal, both conditions can arise due to obesity. “High uric acid levels, responsible for gout, are more prevalent in people with obesity or other metabolic conditions, which is caused by a combination of factors like poor lifestyle, high blood pressure and dyslipidemia. These factors can also lead to diabetes,” she says.
- Restriction of movement: Dr Saboo explains people with gout can also develop diabetes, as the pain can restrict their daily activities and movements. “A reduction in physical movement increases the chances of obesity,” he says.
- Fructose-heavy beverages: Dr Aggarwal says that both gout and diabetes can be linked to the consumption of high-fructose beverages available in the market. “Besides causing obesity and diabetes, the fructose present in these sweetened beverages gets converted to uric acid. As a result, people might have a higher uric acid level, which increases the risk of developing hyperuricemia and gout,” she explains.
- Carb-heavy diet: Dr Saboo explains that those diagnosed with high uric acid levels are often advised a low protein diet. As a result, they resort to having more carbohydrates, which may lead to weight gain and diabetes.
- Genetic causes: Dr Aggarwal says that certain genetic factors in some people can cause uric acid to precipitate into their joints and kidneys, increasing the risk of developing gout. Similarly, some people have a genetic predisposition for developing diabetes, while others are predisposed to both diabetes and gout.
Managing gout and diabetes
Dr Saboo explains that people with high uric acid levels and diabetes should undergo regular screening, consider physiotherapy for pain management, adhere to the prescribed medication and follow their nutritionists’ guidelines for a balanced diet.
According to Dr Kumar, measures that can be taken for managing gout and diabetes include:
- Reducing high protein intake (like red meat and certain seafood)
- Ensuring adequate hydration
- Maintaining an ideal body weight through regular exercise and an active lifestyle
Takeaways
- People with elevated uric acid levels may experience the same comorbidities (like obesity, high blood pressure and high lipid levels) as those with diabetes.
- Diabetes and gout can occur in people with similar lifestyles. However, genetic factors may also contribute to the two conditions.
- Taking measures like reducing high protein intake, ensuring adequate hydration and maintaining an active lifestyle can help manage both gout and diabetes.
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