The inflammation that comes with rheumatoid arthritis may increase your risk for diabetes. Follow these smart health tips to protect yourself.

Having rheumatoid arthritis (RA) makes you about 50 percent more likely to develop type 2 diabetes than those without the autoimmune disease. Experts aren’t exactly sure what’s behind the connection, but many say that the link may be due to the inflammation that occurs with RA. “A lot of inflammation causes insulin resistance, which increases blood sugar levels,” says Scott Zashin, MD, a rheumatologist and clinical professor of medicine at the University of Texas Southwestern Medical School.

Being sedentary because of RA pain further increases your risk for type 2 diabetes. And any steroid drugs you take for RA can make it harder to control blood sugar. “When you have a lot of steroids in your body, your body makes glucose because it assumes you’re going to need it for some kind of ‘fight or flight’ response,” says Wayne Evron, MD, an endocrinologist and medical director of the Joslin Diabetes Center in Pittsburgh. “But if you’re giving them to someone to control their RA, it can make their sugars higher.” 

The connection between type 2 diabetes and RA isn’t yet set in stone. “The data is kind of mixed,” Dr. Zashin warns. “There have been studies published showing an association between RA and diabetes, and some that haven’t shown an association.”

Type 1 diabetes, which occurs when the body’s immune system attacks the pancreas, may also be a risk for people with RA. Though it used to be called juvenile diabetes, people can develop type 1 diabetes at any age. And because type 1 diabetes and rheumatoid arthritis are both autoimmune diseases, they can occur together. Dr. Evron explains that they may be prevalent in families that tend to get autoimmune diseases  And researchers have recently identified a gene named PTPN22 that can increase the risk for type 1 diabetes, RA, and other immune disorders.

Though there’s no known way to prevent type 1 diabetes, it may be possible to reduce your risk for developing type 2 diabetes when you have RA. According to a study published in the journal Arthritis Care and Research more than 1,500 people with RA, who were given the class of RA drugs known as TNF-alpha inhibitors, had a reduced diabetes risk.  The drugs work by blocking the action of TNF-alpha, an inflammation-causing substance in the body that is also associated with diabetes. Examples of TNF-alpha inhibitors include the drugs etanercept and adalimumab. TNF-alpha inhibitors are very powerful, so a great deal of caution should be used when considering them solely for diabetes prevention. “They can lead to decreased immune function,” Evron says.

If your RA isn’t at the point where your doctors are suggesting TNF-alpha inhibitors, there are healthy lifestyle habits that can also go a long way toward reducing your risk for type 2 diabetes, and without side effects.

• If you are above your ideal weight, losing as little as 5 percent of your body weight can help prevent or delay the onset of type 2 diabetes.
• Moderate exercise like brisk walking or biking for at least 2½ hours a week can also boost your health.
• And a diet rich in fruits, vegetables, low-fat dairy, and whole grains delivers health benefits, too.

"All of those things are important in controlling blood sugar,” Zashin says.