How to Treat Arthritis if You Have Diabetes

For people with diabetes and arthritis, there are a number of treatment components. If you have both conditions, you may choose to work with multiple specialists to find approaches that work for both conditions.

Blood Sugar Control

Kaniecki notes that in general, diabetes control is good all around. He says that better diabetes control might decrease risk for some complications like frozen shoulder as well as decrease risk for infection. He adds that people who have their diabetes controlled lose weight in general, which then leads to less stress on joints and less of an inflammatory response.

Medications

Medications can be a helpful component of arthritis management, but the specifics depend on your type of arthritis.

Some possible medications used in arthritis treatment include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) may be helpful in the treatment of osteoarthritis and can help relieve pain and improve joint function. Andrew I. Spitzer, MD, an orthopedic surgeon at Cedars-Sinai Medical Center in Los Angeles, notes that caution may be warranted for people with diabetes who have kidney problems or cardiovascular disease associated with diabetes.
• Analgesics such as acetaminophen, should be avoided if you have severe liver problems.
• Steroids reduce inflammation and are an important treatment for inflammatory arthritis types. But both oral and injectable steroids can lead directly to higher blood sugars, so people with diabetes should be cautious.
• Other injection treatments, such as hyaluronic acid and prolotherapy, can help with joint pain but are not appropriate for all types of arthritis, though Dr. Spitzer says their impact may be somewhat limited.
• Disease-modifying antirheumatic drugs (DMARDs), including biologics, can treat the root cause of ankylosing spondylitis, psoriatic arthritis, or rheumatoid arthritis and may benefit blood sugar, too. Kaniecki says immunosuppressive medications should be taken with caution, however, since people with “poorly controlled diabetes are at higher risk for infection.”
• Duloxetine, an antidepressant, may be beneficial in helping with pain relief in knee osteoarthritis, though it may increase blood sugar levels.

Of the above choices, Kaniecki highlights steroids as the trickiest option for people with diabetes. “They help reduce inflammation and can help control symptoms quickly,” but he tries to use them sparingly. He says it can often come down to a conversation with the patient about how steroids will impact blood sugar if they should be used. It’s important to discuss adjunct therapy options with your healthcare team to make sure they’re performed safely and don’t negatively impact your diabetes management.

Non-Medicinal Therapies

In addition to medications, there are also lifestyle changes and other therapies that may be a helpful part of arthritis treatment. It’s important to discuss adjunct therapy options with your healthcare team to make sure they’re performed safely and don’t negatively impact your diabetes management.

Options include:

• Physical or occupational therapy can help address the aches and pains of day-to-day living with joint disease.
• Acupuncture involves using small needles and may help with arthritis pain, such as in osteoarthritis.
• Exercise can strengthen muscles to better support the joints, and burn calories that help you lose weight.
• Massage could help improve physical functioning in people with osteoarthritis.
• Tai chi or yoga incorporate aspects of deep breathing and meditation to help center and relax you.

Kaniecki says that people with diabetes, particularly who also have neuropathy, should get regular foot examinations to monitor for complications and infection, since infection can affect arthritis medication use and overall health.

Weight Loss

Sometimes, doctors will recommend weight loss in the management of type 2 diabetes and different types of arthritis, since it can improve outcomes for both conditions. For people with type 2 diabetes who are overweight or have obesity, weight loss can help decrease insulin needs and lower A1C levels. Weight loss may also make blood sugar management easier for people with type 1 diabetes who are overweight or have obesity.