Type 1 Diabetes and Rheumatoid Arthritis (RA)

Question

I have Type 1 diabetes and have recently been diagnosed with RA. What are the effects of DMARDs on diabetes/glucose levels or vice versa?

Answer

With type 1 Diabetes it is very important to maintain optimal control of your blood sugar.  Some medications for RA can affect diabetes.  The biggest offender is probably prednisone and other steroids. These will often raise blood sugar levels, sometimes even from a steroid injection into a joint.  When doses of steroids are increased, more insulin or other medications may be needed to control blood sugar.  The opposite can happen when steroids are discontinued or tapered.  Patients with diabetes also have an increased risk of infection.  Because many DMARD medications, especially biological agents, can increase the risk of infection, it is very importnat  for patients with diabetes to be vigilant in preventing infection, and in attending to any fever, or localizing signs of infection (such as cough with phlegm, discolored nasal discharge, fever, skin redness, urinary burning) promptly by notifying a health care provider for treatment. 

Clifton Bingham, III, MD

About Clifton Bingham, III, MD

Associate Professor of Medicine
Director - Johns Hopkins Arthritis Center