Arthritis and diabetes may go hand in hand

Is the condition of arthritis and prediabetes related? Physical inactivity and obesity are two factors associated with an increased risk for developing type 2 diabetes, and arthritis has been determined to be a barrier to physical activity among adults with obesity. 

A recent analysis combined the 2009-2016 National Health and Nutrition Examination Surveys (NHANES) dataset and has found that arthritis among adults with prediabetes was 32 per cent. People suffering with both conditions arthritis and prediabetes and also, obesity and physical inactivity were found to be 56.5 per cent and 50 per cent, respectively. 

The importance of this data is to understand that arthritis-specific barriers to physical activity can be one of the causes for diabetes, explains Dr Krishna Subramanyam, senior orthopaedic and joint replacement surgeon at Yashoda Hospitals. 

A recent study published in Morbidity and Mortality Week report, states that one in three of adults with arthritis were also in a prediabetic condition? If so why?
Diabetes and joint pain are considered to be independent conditions. Joint pain may be a response to an illness, injury, or arthritis. It can be chronic (long-term) or acute (short-term). Diabetes is caused by the body not using the hormone, insulin, correctly, or insufficient production of it, which affects blood sugar levels. A hormone related blood sugar condition can affect joint health after the development of diabetes. But is not necessarily one of the causes for development of the disease. 

Does this mean that those who have a condition of arthritis must actually check on their physical activity so that obesity and both diabetes can be kept away?
Osteoarthritis (OA) is the most common form of arthritis. It may be caused or aggravated by excess weight. OA is not directly caused by diabetes. Instead, being overweight increases the risk of developing both type 2 diabetes and OA. Obesity is a major cause in both these conditions. 
In arthritis, we find that physical activity is limited because of the pain. Due to this reason there is development of diabetes.

What is the impact of this study in health-care professions?
Excess weight is now coming across as a risk factor for various diseases. In osteoarthritis too, the main stress is laid on managing weight. Excess weight puts more pressure on the bones. Similarly, those who are diabetic and have excess weight, controlling blood sugar levels is a challenge too. The crux of this study is to effectively manage arthritis in patients so that their weight is controlled and hence does not push their blood sugar levels higher. Arthritis is prevalent highest amongst those who are over 65 years, to the extent of 55 per cent. In them physical activity can be a challenge. But defined programmes that will keep them physically active, need to be opted. The prevalence of arthritis in adults of the age group of 20 to 44 years is 10.1 per cent, and 45 to 64 years is 34.8 per cent. In both these categories, better and effective management is possible by advising them exercise regimes which will not hurt their joints but which will help to keep obesity at bay. Walking, swimming and also yoga exercises are advised for them. Other strength training programs must be in professionally guided so that their joints are taken care of and they are not hurt.

Those who suffer from arthritis have a sharp shooting pain and often complain of being incapable of carrying out any physical activity. In this condition, how can they be guided?
We have found that those who engage in light but functional physical activity are able to manage their condition of arthritis properly. Hence the stress is on guided programmes where the physiotherapist has an idea of what is suitable for the person. Each of them are then given a specific regime. Light walking is also found to help as the there is constant movement and then the body is capable of building it to the next level. Combination conditions like arthritis with obesity and no proper physical activity, takes a lot of time to build up. But exercise will help to improve the physical function, mobility, reduce blood glucose levels which then lowers the risk of developing Type 2 diabetes and the alleviated pain related to arthritis. Adequate physical activity with a controlled weight is the best self-management strategy to keep both arthritis and diabetes at bay. There is enough evidence, that weight loss can in turn help reduce joint pain and improve function. A 5.1 per cent reduction in weight over 20 weeks can reduce pain and functional disability in patients with knee osteoarthritis and obesity.