Albrecht K, et al. - In a study sample of RA patients, the prevalence of diabetes was determined, along with its impact on self-reported outcomes and health care. A high prevalence of diabetes and its association with known sociodemographic factors were documented. Despite a high disease burden, frequent hospitalization, and presentation with further comorbidities, more than 40% of patients with RA and diabetes were not under rheumatological care.

Methods

• Random selection of RA patients, between the ages of 18 and 79 years, was done from a nationwide statutory health insurance fund.
• These patients were surveyed about rheumatological care and disease burden.
• Furthermore, researchers analyzed comorbid diabetes (E10–14) regarding age, sex, BMI and socioeconomic status.
• They compared disease burden, comorbidity and prescriptions in RA patients with and without diabetes.
• Using multivariate regression, they identified predictors of rheumatological care.

Results

• Diabetes was detected among 498 (20%) of the 2535 RA patients.
• Data showed that in males, in older patients, in patients with a higher BMI and in those with a lower socioeconomic status, diabetes was more frequent.
• Researchers observed that in RA–diabetes patients, all disease outcomes were poorer and were mainly attributable to a higher BMI.
• RA–diabetes patients vs patients without diabetes (all P < 0.05) received less DMARDs (40% vs 48%) and had more hospital stays (41% vs 30%).
• Findings demonstrated higher rates of cardiovascular disease (35% vs 15%), depression (39% vs26%) and renal failure (23% vs 8%) in RA–diabetes patients (all P < 0.0001).
• In addition, it was noted that they were less frequently treated by rheumatology specialists: 57% vs 67%; odds ratio = 0.64 (95% CI: 0.45, 0.92), after controlling for confounders.