Patients with rheumatoid arthritis (RA) have a higher-than-normal risk for insulin resistance, a new study has concluded.
Simply put, insulin resistance is a condition in which the body produces insulin but doesn’t utilize it correctly, putting patients at risk for pre-diabetes.
A link between RA and diabetes has long been known, so the risk for insulin resistance may not be a surprise to many. But what it means and what can be done about it is a different topic.
RA, Atherosclerosis, and Insulin Resistance
According to the authors of the study, RA patients showed an increase in insulin resistance, but they were not at risk a greater risk of heart attacks or atherosclerosis related to insulin resistance.
The study also found that patients taking prednisone — a steroid often prescribed to treat rheumatoid arthritis — had an increase in insulin resistance.
Overall, the increase in insulin resistance was evident in both men and women with RA, although seemingly more so among white patients. Patients with a higher body mass index (BMI), particularly those with more fat in the stomach area, had a higher risk as well. Doctors have noted how important a role BMI plays in our health, particularly among RA patients.
Researchers indicated that average insulin resistance levels were 31 percent higher in the group of patients with RA than in those without the disease. They cautioned, however, that this link and the link between atherosclerosis or other heart issues was unclear.
What RA Patients Can Do to Regulate Insulin
“A person can fight back against insulin resistance by making sure that they follow the number one rule of blood sugar balancing, which is to eat fat, fiber, and protein at every meal, and preferably every snack as well,” said Maria Claps, a certified functional diagnostic nutrition health coach of Basking Ridge, New Jersey.
“Causing the pancreas to work at ever increasing rates of insulin hormone production by eating refined carbohydrates at every meal, without regard for the other macronutrients (fat and protein) may be a cause of insulin resistance,” she added.
Claps noted we live in a world that is infiltrated with carbohydrates at every turn.
“We are a society of people that can’t imagine life without cheap, refined carbohydrates,” she said. “Even so-called healthy carbohydrates such as whole grains and starchy vegetables are best paired with a little bit of healthy fat and clean protein.”
Graciela Buendia, a certified integrative nutrition health coach from Naples, Florida, agrees that a healthful diet and positive lifestyle changes — whether in RA patients or others — are an important part of controlling insulin levels.
“Insulin resistance can be prevented and in some cases reversed by avoiding processed foods, added sugars, maintaining a healthy weight, exercising, and eating a diet rich in real foods (vegetables, fruits, good quality animal proteins, seeds and nuts),” she said.
Pharmaceutical drugs can also ease issues relating to insulin in RA patients. Older studies have shown that, sometimes, treatments for inflammatory arthritis and diabetes can overlap. In some RA patients, treatment with the biologic drug Remicade has been known to decrease insulin sensitivity.
Other diabetes-specific medications can help, too. Stephanie Turner of Charlottesville, Virginia, can testify to that fact.
“I have RA and diabetes, but I take metformin. In six months I brought my A1C down from 11.9 to 6.1 with metformin, diet, and exercise. I'm happy to talk about my success. Oh — and I lost 34 pounds and went from a size 22 to a size 16,” said Turner, who took a combined approach of pharmaceutical drugs and lifestyle modifications to manage her diabetes and rheumatoid arthritis.
For now, researchers clearly see a link between RA and insulin resistance — but the full impact of this link is yet to be completely understood.