Diabetes and Gout

Diabetes and Gout

By: Dr. J. Hector Sanchez Mijangos

Specialist in Internal Medicine

Director of OMEGA diabetes Clinic

People living with Diabetes often also suffer from other conditions known by the name of “comorbidities”, among which are obesity, hypertension (high blood pressure), dyslipidemia (high cholesterol and/or triglycerides) and gout; the latter is associated less frequently with Diabetes than the other diseases listed above; however, these have to be diagnosed and treated effectively, as they could affect important organs like the kidneys.

Gout is characterized by an elevated blood uric acid level, above 7 mg/dL. Uric acid is produced in small amounts in the body and its concentration increases to abnormal levels in some people when they consume animal foods; for example, red meat or legumes (bean, beans and lentils) and drink alcoholic beverages such as beer. Gout is more common in men, in 95%, and at the age range of 40 and 50 years. When blood uric acid concentration is lower than 7 mg, it remains dissolved in the body fluids, but when the concentration rises from this figure, it can no longer remain dissolved and “suddenly” crystals form in the joints from a uric acid form called “monosodium urate”; this can affect the big toes, the ankle or knee; it feels as if suddenly a thorn got stuck in a person’s joint, which causes intense inflammation, pain and a temperature rise due to the affected joint; it is so painful that it can’t be tolerated, not even the rustle of sheets on the affected joint; this is called “acute gout attack”, and has to be treated by a doctor with analgesics and anti-inflammatory drugs; however, to prevent these attacks in the long run, you need to eat less animal foods, legumes and consume less alcohol and often require medications that lower blood uric acid such as “allopurinol”.

In most patients who’ve suffered multiple acute gout attacks, they may not suffer from acute attacks for a long time; but if uric acid levels remain high, monosodium urate crystals will accumulate in the tissues, such as elbows, fingers and ears, and look like “white stones” under the skin, called tophi.

Although a strong association between diabetes and gout has been observed, the mechanisms that link these diseases haven’t been unequivocally identified. It’s important to emphasize that people who suffer from Diabetes find it difficult to control, any infectious process, inflammatory aggression to the tissues and even stress can unbalance the disease as hormones responsible for “circulating” more glucose are released to defend the body; however, not having enough insulin increases blood glucose levels. This can happen in some patients during an acute gout attack and, therefore, may require a temporary adjustment of insulin dose or diabetes medications.

Another point to note is that Diabetes treatment is based on healthy eating and exercise; and gout treatment also emphasizes on healthy eating, especially by reducing the consumption of red meat, alcohol and legumes.

Monosodium urate crystals also accumulate in the kidneys causing stones and direct damage to this organ, which is why it’s very important to control and maintain control of one’s blood uric acid levels.

Dr. J. Hector Sanchez Mijangos

Specialist in Internal Medicine

Director of OMEGA diabetes Clinic

If you live in Mexico and have Diabetes and gout, we invite you to get a free assessment or visit our website www.clinicaomegadiabetes.com.mx