RA and diabetes: Let’s get real

While perusing the latest news about rheumatoid arthritis, I came across an article in Athritis Today that announces that researchers have linked RA to diabetes.

To quote the article:

The risk of getting diabetes is about 50 percent higher in patients with autoimmune forms of arthritis, such as rheumatoid arthritis, or RA, and psoriatic arthritis, according to a new study in the June 28th, online edition of Annals of the Rheumatic Diseases.

Excuse me, but duh.

Further down in the article comes this jaw-dropper:

Dr. Solomon says the exact cause of the increased diabetes risk is not known.

They follow up with some educated guesses, but they’re kidding, right?

Of course people who suffer from RA and PA (and other forms of arthritis, I bet) are more likely to get diabetes! (I’m guessing the researchers mean Type 2 diabetes, the kind that generally affects middle-aged and older adults, though the article doesn’t make that clear). People with painful autoimmune diseases find it very difficult to get adequate exercise or even, sometimes, to get out of bed in the morning. Even everyday exercise, like the kind you get vacuuming the carpets or weeding a garden, can be impossible when joints are painful and inflamed. Walking can be impossible.

That means that many of us with RA gain a lot of unwanted weight. That makes it even harder to exercise or even move our bodies normally. So we gain more weight, and exercise even less, which leads to depression and yet more weight gain. Add to that being middle-aged, and now we’re also likely dealing with metabolic syndrome and yes, a greatly increased chance of becoming diabetic, too.

What a vicious circle that is!

Thing is, we’re no different than any other “group” of individuals when it comes to developing diabetes, except that RA adds almost daily pain and stiffness to the mix of reasons we don’t get enough exercise to counterbalance the number of calories we eat.

I’m always disappointed when I read “news” about studies like this.  Someone spent their time and money on this study? Shoot. They could have just asked me (or just about any other person with RA) about it and saved themselves all that trouble and expense.

Here’s the deal, though: Even with RA, PA and other painful autoimmune diseases, there’s no reason we have to resign ourselves to that 50 percent probability of developing diabetes. Like our “healthy” brothers and sisters out there, we can avoid that awful disease by eating mindfully. Sure, exercise can help, but it’s not a requirement for weight loss. What is required is to say “no” to sugary foods, along with processed foods and beverages that are loaded with sugar and/or high fructose corn syrup. This doesn’t mean we can’t ever have those foods. It just means we need to make those foods a rare treat instead of a daily part of our diet.

We also need to avoid the high carbohydrate foods that our bodies convert into sugar once they’re digested, like white flour, white rice, pasta made with white flour, and potatoes. If we stick to wholegrain breads, pastas, brown rice (I absolutely love brown basmati rice, by the way) and other whole grains, we’ll still get the carbohydrates our bodies need for fuel, but without the massive sugar spike that plays havoc with our blood glucose levels and makes us more likely to develop diabetes.

If we’re meat eaters, we need to choose chicken and fish over beef. Our bodies digest these meats far more efficiently, they have less or none of the saturated fat that beef is loaded with, and fish, in particular, comes with other excellent natural metabolic benefits. Here again, it doesn’t mean you can’t ever have a nice steak, sizzling hot off the grill, the occasional hamburger or Grandma’s Sunday meat loaf. It just means that those meals are special. A treat. Rare.

We also have to listen (finally!) to our mothers and eat our vegetables. Lots of them. We need to choose fresh fruit for snacks and dessert instead of chips, donuts or cookies. Yeah, I know.  It’s tough. But it’s also very doable, and the results of nutritious eating are many and tangible. Who doesn’t feel better when they drop a couple of dress sizes? Who doesn’t feel better when they don’t have to worry about breaking the plastic patio chairs when they sit down?

Once we’ve made these vital changes in our diets, then comes simple portion control. We must eat less of everything. If we have a good day, pain-wise, tossing in some moderate exercise to burn a few calories and strengthen our muscles, bones and joints can’t hurt a bit, either. But smaller portions are key. Less food, eaten slowly, attentively and with real pleasure allows our brains to say “I’m full!”  sooner. Big portions, gulped down without much attention overwhelm the brain’s satiety signals. Eating less food more slowly means we leave the table feeling well, energized and light on our feet instead of stuffed to bursting, uncomfortably heavy through the middle, and drowsy.

So good-bye, “50 percent higher chance of developing diabetes.”  To me, studies like this only scare-monger. They don’t really address the reasons behind the statistic, at least not within the first couple of paragraphs. And because of that, they just make people with RA feel that much more fearful and hopeless.  Like, “Oh, great. This means I’m going get diabetes one of these days, too. Thanks a lot, RA.”

I think it’s vital that we know how much control we actually do have over our long-term health and wellness. It’s worthwhile to learn about it. It’s worthwhile to put in the effort it takes to eat healthfully and mindfully. It’s worthwhile to do all we can to be healthy, even as we face the daily challenges rheumatoid arthritis throws at us.

We don’t have to accept these glum predictions about our possible, upcoming bad health. We don’t have to sit by helplessly as we get sicker and sicker. When it comes to developing Type 2 diabetes, we do have some control. We can change that study’s results. We don’t have to be a sour statistic.

I’m doing everything I can to ensure that I never develop Type 2 diabetes.  Frankly, I just don’t need the added misery and hassles on top of the RA I already have. How about you?

6 thoughts on “RA and diabetes: Let’s get real

  1. Though my parents and friends think I’m crazy, I’ll do just about anything to try to keep away all of these “side issues” related to RA. I take the calcium to ward off osteoporosis, and the omega 3’s to help with cognitive & cardiovascular issues, and whatever else I think will help. I’ll eat healthier foods instead of the easy pre-processed already-made stuff. Yes, that means more pills taken and more work for me and more expense put out, but this is my life and I want to be sure it’s a good one.

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  2. I’m certainly no expert, but I don’t know whether to laugh or cancel my subscription when I read stuff like this from the so called experts. You’re right about the diet (I hate that word) but I have to have one steak and one burger a week to keep going. I love this time of year because we get to eat fresh veggies from the garden.
    I’m doing most everything I could do to prevent heart disease and diabetes. I’m eating reasonably well, exercising when I feel up to it, this week I’m doing tests for stoke, aortic aneurysm and PAD, but I’m not going to let articles like this control my thoughts and fears.

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  3. This got me curious enough that I went searching for more information. Unfortunately, they want $ for the full text of the paper, so I only read the abstract.

    The way the AT article is written, it certainly sounds like they’re talking about type 2 – definitely a no duh! worthy study. What I find interesting is that some people consider type1 diabetes an autoimmune disease. My mom was in her 40’s when diagnosed with type 1, and since my diagnosis I’ve wondered what kind of connection there might be.

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  4. If anyone wants it I can get the journal paper for them, just leave a message of email me.

    Giving it a quick look over, they don’t differentiate between type 1 and type 2, nor do they take into account body mass, but from what I can tell, they are interested in the relation between inflammation and diabetes. I think what the paper is trying to say is that the inflammation from RA may be increasing the risk of diabetes itself, independent of lack of movement caused by pain. The AT article kind of completely missed that point.

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  5. Now, they are mentioning this? It is well known that diabetes is also an autoimmune disease. With Type 1, the immune system attacks pancreas cells that produce insulin. Anti-nuclear antibodies are found in autoimmune disease patients. Some people, not all, have anti-nuclear antibodies that develop into diabetes and any number of autoimmune diseases. However, having certain anti-nuclear antibodies does not mean a person will develop an autoimmune disease; it just means that they have a higher risk of development than people that do not have that factor. So, in addition to the factors that you mentioned, that genetic factor plays a role.

    I also think 50 percent is too high of a number. You are absolutely right that any person could have figured that. I am so tired of these correlation studies. I would love to see a medication out that increases the chance of remission because only 30% of RA patients go into remission. Some researchers believe that 60% of patients on biologics called TNF inhibitors – adalimumab (Humira), Enbrel, infliximab (Remicade) – and the newer biologic agents, such as abatacept (Orencia) or rituximab (Rituxan) are seeing lower disease activity. So hopefully, that 30 percent starts to go up.

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  6. I couldn’t have said this any better. I too get tired of the so called experts who never consult with people who actually have the disease.

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