Laddie: Please welcome guest-blogger Rick Phillips who has written a 3-part series about Diabetes and Rheumatoid Arthritis. To learn more about Rick, please check out my recent post that introduces him to the readers of Test Guess and Go.
Rick Phillips: RA – Diabetes and Autoimmunity
As I move to wrap up this series, I am reminded that I am often accused of writing an epistle when a sentence will do the trick. I cannot help it. I am trained as a bureaucrat, so I tend to spin in place a lot with my writing. That is a bad habit I am working to break. If you have stuck with me up until now, I hope you have found the effort you expended a wise investment.
I really do owe a debt of gratitude to Laddie for publishing my work. I am reminded that I am a guest here and the first rule of being a guest is to not overstay your welcome. I hope I have not overstayed my welcome on Laddie’s site. I am exceedingly grateful for her hospitality. Rheumatoid Arthritis (RA) is something that interests me a great deal of course.
After diagnosis, I wondered: “Are RA and Type 1 diabetes connected? And if so, how?” They are. While I had never heard of such a connection before I was diagnosed with RA, the connection, the how, and why these diseases are connected really started to interest me.
First and foremost, RA is an autoimmune disease as is Type 1 diabetes. In both diseases, it is thought that the autoimmune system mistakes helpful body tissue as being undesirable and in essence revs its engine to attack the body systems it finds offensive.
My dad loved war movies, so I tend to think of it like a war movie. I imagine the autoimmune system (the General) hanging out in headquarters. Suddenly, it notices some movement on the map; someone has mistakenly labeled that movement as the enemy. The labeling is wrong, but the autoimmune system does what it does: it attacks. It sends in tanks, missiles, aircraft carriers-you name it, to battle this new movement. The trouble is the movement is not harmful or the enemy; it is the good guys.
In my case, my autoimmune system first attacked the insulin-making cells in my pancreas. Later, it loaded up and started a war with my joints. Still later, my autoimmune system got tired of hanging around with no new wars to fight, so I was diagnosed with a third autoimmune disease called Ankylosing Spondylitis (AS). AS is like RA of the spine. AS has pretty much the same disease elements as RA, this time just targeting the spinal area. It hurts as well and I had never heard of it before the doctor said I had it. Go figure, another prize in the “autoimmunity-gone-wild” lottery.
So, how are these diseases connected? According to the Arthritis Foundation, there is an overlap between the diseases. This is how they explain that overlap:
Research shows a genetic connection between rheumatoid arthritis and type 1 diabetes. In recent years, researchers have identified a gene called PTPN22 that strongly correlates with the incidence of type 1 diabetes as well as rheumatoid arthritis, juvenile idiopathic arthritis and other autoimmune diseases. (Learn About Arthritis, 2014)
After one gets beyond that, finding the evidence for a link tends to get less pronounced. A very large study in 2010 found the following evidence for a connection between arthritis and diabetes: “Among U.S. adults with diagnosed DM, nearly half also have diagnosed arthritis.” At first blush, that seems like pretty compelling information for a direct link between the two disease conditions. However, once one digs a little deeper, it is discovered that this link has more to do with Type 2 diabetes than Type 1. More than half of the incidence of people with Diabetes Mellitus and arthritis were also judged to have arthritis-attributable activity limitation. While not saying it directly, it does suggest more of a relationship between Type 2 and arthritis than Type 1.
Of course, no matter how you cut it, RA and Type 1 are both autoimmune diseases. Although I searched for several days and could not find a direct link, I still don’t think anyone will be surprised if one day a common thread between the 80+ autoimmune diseases isn’t found and shown.
There is one other very significant fact that needs highlighting. Almost 3 in 4 people with RA are female (“Learn About Arthritis,” 2014). No one knows why women are more susceptible to RA than men. Whatever the reason, RA is a tough disease. The combination of RA and Type 1 diabetes is even tougher to deal with. I hope this series has been informative. If you would like to discuss it further, look me up at my blog at TuDiabetes or send me an email at Rphil2@Yahoo.com.
Special thank-you for help in preparing this series goes to: Erin Mattingly, for administrative support, Carol Eustice, Ask.com arthritis expert, and of course Laddie for allowing me to publish such a long blog series. (Laddie, I hope I did not run anyone off!)
Rick, thanks so much for your very informative posts. I’ve learned more this week than I have in a long time.