Diabetes and Gout

“Hyperuricemia, characterized by elevated uric acid levels in the blood, is commonly associated with gout,” says Farzaneh Daghigh, PhD, a professor of biochemistry at Philadelphia College of Osteopathic Medicine.

• Too much alcohol
• Consumption of red meat
• Consumption of too much sugar
• Genetics
• Obesity
• Metabolic syndrome
• Diuretics
• High blood pressure

“The two conditions have a common upstream risk factor, which is obesity,” says Stephen P. Juraschek, MD, PhD, a gout researcher and an associate professor of medicine at Beth Israel Deaconess Medical Center in Boston. “We know that a higher BMI and obesity is associated with diabetes and is strongly associated with gout.”

“Hyperinsulinemia, a hallmark of type 2 diabetes, can have major effects on the expression of multiple genes responsible for uric acid disposition,” says Dr. Roman.

“Studies that have looked at diabetes duration over time have shown that gout risk trends downward a little bit and the mechanisms for this are not entirely clear,” says Dr. Juraschek.

Juraschek says there is bidirectionality between the two because of metabolic syndrome, “but I'm not sure I would say that uric acid is explicitly causing diabetes or diabetes is acting directly on gout.”

If you do have both conditions, talk to your doctor about harmonizing your treatments so you can treat each condition without making the other worse.

“Gout has a strong genetic basis, which explains the family history of gout," says Roman. “Although you can manage your diet, you can lower your alcohol consumption, you can do all the things … relying on that to cure or manage gout is not sufficient.”

• High-purine foods: Purines are organic compounds that are essential building blocks of DNA and RNA. When the body breaks down purines, it produces uric acid.

  [14]

   The foods with the highest concentration of purines include beef, chicken, duck, pork and ham, and shellfish.

  [15]

• Alcohol: Alcohol contains purines, too. Limiting or avoiding consumption of beer, wine, and spirits is recommended for patients with gout, regardless of whether or not you’re experiencing a flare.
• High-fructose corn syrup: This is a concentrated form of sugar found in many packaged food products, such as cereals, candy, baked goods, fast food, and beverages.

Many of the foods that people with gout should avoid are the same dietary no-nos for diabetes. Fish, however, because it’s typically lean and high in protein, is a good dietary choice for people with blood sugar issues. Dr. Daghigh says it doesn’t necessarily have to be totally eliminated if you also have gout.

“Seafood provides essential nutrients, and lower-purine options such as salmon or shrimp may be eaten in moderation,” Daghigh says.

Roman is a fan of the DASH diet for people who have both health conditions. It limits sodium, sweets, and fatty meats while emphasizing vegetables, whole grains, and foods rich in protein and fiber. He also says it’s important for people with gout to know which foods are most likely to trigger their gout flare-ups.

• Nonsteroidal anti-inflammatory drugs (NSAIDs), either over the counter or prescription
• Colchicine, an anti-inflammatory prescription drug that treats and prevents gout attacks
• Corticosteroids, which are powerful anti-inflammatories that can be taken in a pill or as an injection in the affected joint

Managing gout when you have diabetes will require ongoing conversations with medical professionals to find what works for your situation.

“It’s essential to consult a healthcare professional to determine the most appropriate course of action, diet, lifestyle modification, and treatment plan based on individual symptoms and health conditions,” says Daghigh.

• Gout and type 2 diabetes often occur together and share risk factors such as obesity, excess sugar consumption, and metabolic syndrome.
• Avoid certain foods and drinks if you have gout, particularly foods high in purines like meat, seafood, and alcohol.
• It may take a little extra work to find a sustainable diet that helps both diabetes and gout, but many of the same foods that people with gout should avoid are also not recommended for those who have diabetes.
• Work with your healthcare providers to find effective medications and food choices that keep blood sugar levels in a healthy zone and prevent gout flare-ups as well.