Diabetes mellitus in rheumatic diseases: clinical characteristics and treatment considerations
Fedorchenko Y. Mahmudov K. Abenov Z. Zimba O. Yessirkepov M.
December 2023Springer Science and Business Media Deutschland GmbH
Rheumatology International
2023#43Issue 122167 - 2174 pp.
New pathophysiological insights are now available on comorbidities in rheumatic diseases (RDs). Several nationwide studies point to the fact that comorbid diabetes mellitus (DM) increases the risk of adverse outcomes in patients with various RDs. Genetic factors, intensity of systemic inflammation, anti-inflammatory potential of therapeutic agents, and duration of RDs have been insufficiently explored in the context of comorbidities. Some disease-modifying antirheumatic drugs (DMARDs) have demonstrated a potential to improve the glycemic control while glucocorticoids (GCs) have worsened it, particularly in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). Anti-TNFalpha agents in combination with hydroxychloroquine (HCQ) have been associated with a reduced risk of DM in patients with RA, ankylosing spondylitis (AS), Sjögren syndrome (SS), and SLE. Better understanding of confounding factor of currently available antirheumatic therapies in patients with DM and RDs will pave the way for a tailored approach, limiting the severity of clinical manifestations and reducing the mortality risk.
Comorbidities , Diabetes mellitus , Hyperglycemia , Rheumatic diseases , Rheumatoid arthritis , Systemic lupus erythematosus
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Department of Pathophysiology, Ivano-Frankivsk National Medical University, Halytska Str. 2, Ivano-Frankivsk, 76018, Ukraine
Department of Propaedeutics of Internal Diseases, Avicenna Tajik State Medical University, Dushanbe, Tajikistan
Student Polyclinic, Shymkent, Kazakhstan
South Kazakhstan Medical Academy, Shymkent, Kazakhstan
Department of Clinical Rheumatology and Immunology, University Hospital in Krakow, Krakow, Poland
National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
Department of Internal Medicine N2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
Department of Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
Department of Pathophysiology
Department of Propaedeutics of Internal Diseases
Student Polyclinic
South Kazakhstan Medical Academy
Department of Clinical Rheumatology and Immunology
National Institute of Geriatrics
Department of Internal Medicine N2
Department of Biology and Biochemistry
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