What to Know About the Link Between Gout and Diabetes

Experts don’t fully understand the exact relationship between gout and type 2 diabetes, but a few explanations are possible.

What gout is

Gout is an inflammatory condition caused by too much uric acid. Your body produces uric acid as it breaks down purines, which are chemical compounds found in:

• red meat
• beer
• yeast
• some seafood

Your body removes uric acid through urination. But if you eat a high-purine diet — which can cause a high level of uric acid — your kidneys can’t remove the uric acid fast enough. This can lead to a buildup in your joints and tissues, resulting in gout inflammation and pain.

The role of insulin resistance

High uric acid doesn’t only cause inflammation, though. It can also trigger insulin resistance.

Insulin, a hormone produced in the pancreas, helps control the amount of sugar in your blood. Insulin resistance is when your body doesn’t respond well to insulin, causing too much sugar to circulate in your bloodstream.

Physical activity, a moderate weight, and a balanced diet can sometimes reverse insulin resistance. But without treatment, insulin resistance can lead to prediabetes and type 2 diabetes.

Diabetes and increased risk

A history of gout doesn’t only increase the risk for type 2 diabetes, though. A history of type 2 diabetes also raises the risk for gout.

If you have type 2 diabetes and you have overweight, fat around your midsection can make it harder for your kidneys to respond to substances in your body. This may lower their ability to remove extra uric acid from your blood. If your kidneys can’t function as well, uric acid can accumulate and cause gout.

Also, you have a slightly higher risk for gout if you take a glucagon-like peptide-1 (GLP-1) receptor agonist — a medication used to treat type 2 diabetes — compared with a sodium-glucose transport protein 2 (SGLT2) inhibitor, another type 2 diabetes medication.

A 2020 study looked at 295,907 adults with type 2 diabetes. It found that those who were newly prescribed SGLT2 inhibitors had a lower likelihood of gout (4.9 out of 1,000 people) compared with those prescribed GLP-1 receptors (7.8 out of 1,000 people).

This is probably because of the inhibitor’s ability to lower uric acid levels and the likelihood of a uric acid buildup. However, more research is needed.

Gout severity varies from person to person. Sometimes, over-the-counter anti-inflammatory drugs such as ibuprofen and naproxen sodium are enough to bring down pain and inflammation.

For moderate or severe pain, your doctor can prescribe anti-inflammatory medications or corticosteroids. Your treatment might be an injection or a pill and will help to reduce joint pain.

If you have gout that comes back after some time, other prescription medications can block uric acid production and help your kidneys remove uric acid from your body.

If you have diabetes, maintaining a moderate weight and a balanced diet can lower your risk of gout. A moderate weight allows your kidneys to function and remove extra uric acid from your body through urination. Drinking plenty of water also helps your kidneys.

Also, keep in mind that some medications and supplements can increase your levels of uric acid. These include:

• certain diuretics
• aspirin
• high doses of vitamin A and niacin

A gout-friendly diet can lower your risk of gout and improve symptoms during a flare-up.

You might try limiting or avoiding purine-rich foods. These include:

• red meat, such as beef, pork, and lamb
• organ meat, such as liver and kidney
• purine-rich seafood, such as sardines, tuna, scallops, and mussels
• beer
• high-fructose products, such as fruit juice, cereal, and candy

Foods to eat on a low-purine diet include:

• fresh fruits
• vegetables
• grains
• nuts
• potatoes
• pasta
• eggs
• fish
• chicken

To prevent type 2 diabetes if you have gout, and vice versa, try to eat a balanced diet, maintain a moderate weight, and get frequent exercise.

If you have gout, avoid foods that cause a buildup of uric acid, especially since too much uric acid can trigger insulin resistance. Stick with a gout-friendly diet and ask your doctor about medications to prevent flare-ups.

Also, drink plenty of water. Water is part of a balanced diet and can promote healthy kidney function.

If you have diabetes or prediabetes, it’s a good idea to drink more water, follow a meal plan, and get plenty of exercise.

You can treat a mild gout flare-up at home with over-the-counter pain medications and a gout-friendly diet. Contact a medical professional, however, if you have:

• gout that keeps flaring up
• severe pain
• other complications, like kidney stones

You should also see a doctor if you have symptoms of diabetes. These include:

• frequent urination
• blurry vision
• dry skin
• numbness
• increased thirst

The relationship between gout and type 2 diabetes isn’t fully understood, but being diagnosed with one can increase your risk of the other.

A few ways to help prevent gout and type 2 diabetes include:

• maintaining a moderate weight
• eating a balanced diet
• drinking plenty of water
• getting regular exercise
• avoiding purine-rich foods