Gout and diabetes are both metabolic syndromes, which often accompany and affect each other. Their occurrence is related to the disorder of sugar and lipid metabolism in the body, and is also the main culprit that further leads to cardiovascular and cerebrovascular diseases.
Statistics show that the probability of diabetes in gout patients is 2 ~ 3 times higher than that in normal people.
Some people predict that gout will become the second largest metabolic disease after diabetes in China in the next 10 years, while type 2 diabetes will remain the number one culprit of metabolic diseases.
It is precisely because type 2 diabetes and gout have many similarities in the process of occurrence and development that when gout patients suffer from diabetes at the same time, they all need to change their unhealthy lifestyle and combine drug therapy when necessary.
Let’s learn more about the what that patients with both diseases need to pay attention to in diet and drugs respectively.
Diet
In addition to a low purine diet, friends with diabetes should also pay attention to the following points:
- Reasonable arrangement of protein, fat, carbohydrate and other nutrients, to achieve a scientific and balanced diet; A small number of meals, not less than three meals a day, when eating to chew slowly; Eat more high-fiber foods to facilitate the drop of blood sugar and smooth stool. Eat less sugar, less salt and a light diet. No smoking, try not to drink.
On the pharmaceutical side
In terms of drug treatment, in general, the use of drugs for diabetes generally does not cause acute attacks of gouty arthritis. However, different types of hypoglycemic drugs have different effects on uric acid.
1. Sulfonylurea hypoglycemic drugs
Sulfonylureas are the most commonly used oral hypoglycemic drugs for diabetic patients.
Acetylsulfonylurea: The first generation of sulfonylurea drugs have dual effects of lowering blood sugar and uric acid. The uric acid reduction time can last for 8-10 hours after taking it. However, the drug has a long half-life and is easy to accumulate and cause hypoglycemia attacks. It has not been widely used in clinical practice.
Glibenclamide, Glimepiride and Gliclazide: If used for a long time, it may affect renal function, reduce uric acid excretion, thus increasing serum uric acid and increasing the risk of acute attack of gout. People who take such drugs for a long time must have their renal function reviewed regularly.
Gliquidone: After long-term use, it still has little effect on uric acid and is a good choice for gout complicated with diabetes.
2. Biguanidine hypoglycemic drug
Advantages: Suitable for obese people.
If diabetic patients are overweight, many clinicians like to use biguanide hypoglycemic drugs, which can help diabetic patients lose weight to a certain extent.
Disadvantages: Affect uric acid excretion.
However, an important adverse reaction of biguanidine drugs is that after taking the drugs, lactic acid will accumulate in the body and inhibit uric acid secretion in the proximal convoluted tubules of the kidney, which will reduce uric acid excretion and increase blood uric acid. Gout patients should be cautious in using this kind of drugs.
3. Insulin
Insulin is a star drug in the treatment of diabetes and is also the best choice for many diabetic patients.
Some studies have pointed out that when insulin participates in human metabolism, it can promote purine to synthesize uric acid, increase blood uric acid and increase the chance of gout attack. Do gout patients need to abandon such an important treatment method?
The answer is no.
Clinically, insulin is a normal hormone in the human body. Diabetic patients suffer from increased blood sugar precisely because of the relative shortage of insulin in the body. Proper supplement of insulin is of great help in controlling blood sugar, but has little effect on increasing uric acid.
Clinically, it is extremely rare for gout patients to suffer from aggravation of gout due to insulin use.
Therefore, patients with gout complicated with diabetes should use insulin boldly as long as they have indications for insulin use.
If you have a long history of gout, don’t forget to pay more attention to your blood sugar. If you suffer from these two chronic diseases at the same time, you should pay more attention to improving your daily living and eating habits, exercising properly and returning to regular consultations.