Research Paper about Rheumatoid Arthritis
Rheumatoid arthritis is a chronic inflammatory illness and skeletal disease that causes joint discomfort, loss of function, and a lower quality of life. Over the past twenty years, treatments for rheumatoid arthritis have become more effective. Better developed technology and further scientific studies have allowed the treatments to become more advanced. With diabetes continuing to be a rapidly growing health issue in not just the United States but worldwide, the question arises, “can rheumatoid arthritis be connected”. According to scientific studies, rheumatoid arthritis has an association to irregularity in blood glucose levels, primarily insulin refusal just like in diabetes. Obesity is both a risk factor for diabetes and rheumatoid arthritis. Understanding the factors linked to diabetes risk in RA (rheumatoid arthritis) should aid medical professionals in making treatment decisions, particularly with patients who have risk factors for diabetes.
The Consortium of Rheumatology Researchers of North America (Corrona) RA registry is a multicenter long-term study in the United States. Over two hundred and fifty centers participate in Corrona. The participants are assessed at clinicals and the data is then recorded. The dataset included 35,448 subjects. Patients who had other forms of arthritis, only had one visit, and who did not receive DMARDs (a drug used for rheumatic arthritis) were excluded. This left 22,943 patients in the study. The data was first recorded when the physician was reported prescribing the DMARD. Exposure to the DMARD was broke down into five different groups. The groups being; TNF inhibitors, other biologic DMARDs, methotrexate, hydroxychloroquine, and other nbDMARDs not uses in the other groups. Each patient did not undergo more than four treatment regiments and were be excluded if they had diabetes. While examining the possible connection between diabetes development and the use of glucocorticoid, the exposure of glucocorticoid was put into groups based on the daily dosage recorded at the starting date.
The study showed incident diabetes to be the main outcome. On the physician survey the presence of diabetes was registered at each visit. The result was taken from a mixture of patient interviews that were used to confirm that the diabetes recorded was a recent discovery and chart reviews. The survey also asked when the date of the diagnosis of diabetes was and any patients who did not include the date were excluded. This left 21,775 people left included in the study.
Patient characteristics were recorded and analyzed. The average age of the patients at the starting visit was around fifty-eight years. The average disease length was around 10 years. Looking at the sex of the subjects 66% of them were female. About 30% of the women had a prescription for an oral glucocorticoid at the starting visit. Within the follow-up time defined for the treatment regiments included in the analysis, 82 incident cases of diabetes were found that were classified as having occurred within the follow up visit. Patients receiving hydroxychloroquine had a diabetes incidence of 1.29 cases per 1,000 person-years, while patients getting other nbDMARDs had diabetes incidence of 3.07 cases per 1,000 person-years. The study also found that the chances of getting diabetes were higher when the dosage of glucocorticoids increased.
A considerably reduced risk of diabetes was found in rheumatoid arthritis patients treated with TNF inhibitors. The study also provided evidence that the risk of diabetes increased when the dose of glucocorticoids did. A combination of DMARDs with treatment regiments have been known to influence joint damage in rheumatoid arthritis. With this information a new concern about the risk of diabetes has come to the surface. Although, not proven evidence in this study has shown treatments for rheumatoid arthritis could cause an increase in the risk of diabetes in patients.
