SYSTEMATIC REVIEW
Association between Diabetes and Rheumatoid Arthritis: A Systematic Literature Review
Jad Okais1, Fouad Fayad1, Rafic Baddoura1, Ouidade Aitisha Tabesh2, Krystel Aouad1, Marcelle Ghoubar3, *, Nancy Sunna3, Eduardo Mysler4
Article Information
Identifiers and Pagination:
Year: 2022Volume: 16
E-location ID: e187431292212020
Publisher ID: e187431292212020
DOI: 10.2174/18743129-v16-e221205-2022-13
Article History:
Received Date: 26/7/2022Revision Received Date: 8/11/2022
Acceptance Date: 18/11/2022
Electronic publication date: 30/12/2022
Collection year: 2022
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Objective:
To examine the risk of diabetes mellitus (DM) in patients with rheumatoid arthritis (RA) and whether the risk is related to conventional risk factors, RA disease activity, and treatment.
Methods:
A systematic literature review (SLR) query was conducted using specified MeSH terms, searching PubMed and EMBASE databases from inception to March 2020. Both cohort or case-control design studies assessing the incidence or prevalence of DM in RA patients were included.
Results:
Of the 1948 articles, 43 peer-reviewed observational studies were selected. A high degree of heterogeneity in study design and reporting was observed, precluding final conclusions.
Based on the studies included, it was observed that DM prevalence ranged between 1% and 20% in RA patients, which was similar to controls (1–29%). The cumulative incidence of DM in RA patients ranged between 1.3% and 11.7% over different time frames. DM incidence rates in patients with RA per 1000 person-years ranged from 5.2 to 16.7.
RA patients may be at higher risk of DM, particularly among those receiving glucocorticoids (GC), while patients on hydroxychloroquine and biological disease-modifying anti-rheumatic treatments (DMARDs) may be at lower risk.
Conclusion:
DM incidence may be increased in patients with RA as a result of more concomitant traditional risk factors and GC exposure. It is unclear whether biologics may have a true protective effect or provide a GC-sparing effect. High-quality studies in large cohorts of RA patients with appropriate adjustment for covariates are warranted to fully investigate the interplay between DM and RA.
