People with severe psoriatic arthritis (PsA) are nearly twice as likely to develop Diabetes Mellitus, revealed in a recent study published in The Journal of Rheumatology. This study was led by Dr Eder and colleagues. She said,“Psoriatic arthritis is significantly related with obesity and its related comorbidities, like DM. Patients with PsA have 43% higher prevalence of developing DM than general population”.

A total 1305 patients were selected for a cohort analysis from a large PsA specialty clinic since January 1978 to November 2014. To figure out relation between PsA activity and DM risk factors, scientists measured swollen joint counts, dactylitis count, arithmetic mean (AM) tender joint counts, Psoriasis Area Severity Index and erythrocyte sedimentation rates. They also measured prevalence of DM and age-standardized prevalence ratio (SPR) of DM as compared to the general population.

Studies found that higher levels of PsA activity enhanced the chances of DM development. The risk was higher among young people. The SPR of the PsA patients suffered from DM as compared to the general population was 1.43 (P =.002). More, during time-to-event analysis, out of 1065 patients’ subset, 73 patients developed DM. The factors, AM erythrocyte sedimentation rate and AM tender joint count (P =.02) predicted DM during PsA activity measurement. Except these two, all other showed an increased percentage of patients having DM during rheumatoid arthritis, an another form of arthritis. However, factors like metabolic syndrome (insulin resistance, obesity and dyslipidemia), unhealthy lifestyle, concomitant skin and topical corticosteroid preparation were more prominent in patients with PsA rather than RA. Therefore, despite of similar characteristics of PsA and RA, the risk of DM occurrence higher in PsA patients.

With its effectiveness, this study shows some limitations also such as -

• Researchers fail to find potential confounding risk factor data in comparison to general population
• The definition of DM in PsA study group was based on increased glucose levels or physician diagnosis, whereas the definition of DM in the general population was based on self-reported analysis
• As the study was conducted only among one specialty clinic, the generalizability of results might be limited

Hence, even after some limitations, this study significantly highlights the need to screen for DM among PsA patients. Especially in those who have higher levels of active joint problem and inflammatory markers.