Blood Testing in RA-Diabetes Combo

Diabetes patients with rheumatoid arthritis less likely to get blood sugar testing

(RxWiki News) Heart disease is a common complication of diabetes. To stay healthy, diabetes patients need to keep a close eye on levels of blood sugar and fat.

Researchers found that people with diabetes who also had rheumatoid arthritis were less likely to get HbA1c testing (a measure of blood sugar levels over time), compared to diabetes patients without arthritis.

However, diabetes patients with rheumatoid arthritis were more likely than those without arthritis to get lipid (blood fats) testing.

"Get blood sugar testing if you're worried about diabetes."

Both diabetes and rheumatoid arthritis increase the risk of heart disease. Yet researchers are unclear of whether having rheumatoid arthritis affects the likelihood of diabetes patients getting recommended testing.

Christie M. Bartels, MD, of the University of Wisconsin, and colleagues set out to see how the presence of rheumatoid arthritis affected HbA1c and lipid testing in older diabetes patients.

They found that diabetes patients with rheumatoid arthritis were 0.84 times less likely to get recommended HbA1c testing, but 1.08 times more likely to get lipid testing, compared to diabetes patients without rheumatoid arthritis.

"HbA1c testing is generally perceived as a diabetes care goal but not a RA priority, which might explain lower testing rates in patients who also have competing RA care needs," the authors write.

High blood sugar is a hallmark of diabetes. When blood sugar levels rise, patients are at a higher risk of complications, including heart disease, blindness and amputation. For this reason, tracking blood sugar levels is a key part of controlling diabetes and diabetes-related complications.

The study's results showed that diabetes patients with rheumatoid arthritis were more likely than those without arthritis to have heart disease. For example, patients with both conditions were 17 percent more likely to have congestive heart failure, compared to those with diabetes only.

Compared to patients with diabetes only, those with both conditions had a 19 percent higher risk of kidney disease, a 77 percent higher risk of lower extremity (legs and feet) ulcers and a 32 percent higher risk of peripheral vascular disease.

According to the authors, "Lower HbA1c monitoring in diabetes patients with RA is a problem because poor [blood sugar] control increases the same microvascular complications that were more prevalent in patients with RA," the authors write.

They recommended that future research looks into how primary doctors and specialists can work together to prevent complications of these two common diseases.

This research was supported by the Health Innovation Program and Community-Academic Partnerships core of the University of Wisconsin Clinical and Translational Science Award.

The study was published July 18 in Arthritis Research & Therapy.

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Review Date: 
July 22, 2012