Rheumatoid arthritis (RA) is an auto-immune disorder that affects 400,000 people in the UK alone, especially women and can start at any age. In RA, the body attacks its own tissues, producing inflammation. It often begins in mid-life and may be linked to genetic factors as well as environmental factors; for example, smoking, intake of alcohol, red meat and coffee, or unidentified infections.
New guidelines recommend ‘treating to target’ and ensuring patients get the right specialist care.
Prevalence of diabetes increases in rheumatoid arthritis patients and prompt diagnosis, the right treatment and rapid access to specialist care can control symptoms and reduce long-term disability, go whether you’re newly diagnosed or already living with RA, your care should follow new guidelines from the health institutes.
Diabetics should pay special care and attention to their legs and feet as they are prone to such troubles.
Joints and surrounding tissues particularly in the hands, wrists and feet become red, hot, swollen, painful and stiff, especially on waking. You may feel more tired than usual, lose your appetite and lose weight, develop fever or sweating or notice a dry mouth and eyes.
Other long-term complications can include anaemia, heart, lung or circulation problems, skin ulcers, liver damage, muscle weakness, nerve damage, bone-thinning (osteoporosis), serious infections and understandably, depression.
You’ll need tests to rule out other causes and urgent referral to a specialist for diagnosis, or for flare-ups.
The new ‘treat to target’ approach aims to achieve remission or low disease activity (depending on your general health, pregnancy and so on).
Doctors recommend prompt treatment with DMARDs (disease modifying anti-rheumatic drugs), such as methotrexate or more powerful ‘biological’ or ‘targeted’ DMARDs, to suppress inflammation and joint damage. These can cause anaemia, low immunity and/or liver and kidney damage (which improve on stopping medication) so you’ll need close monitoring.
You’ll also see the multi-disciplinary team for advice on living as full a life as possible with the help of physiotherapy, occupational therapy, podiatry (footcare), diet, complementary therapy, psychological support, or replacement joint surgery.
Hydroxychloroquine has been shown to reduce diabetes in rheumatoid arthritis by 77%.
Tests You May Need for Rheumatoid Arthritis
- Blood tests for inflammation, rheumatoid factor and anti-CCP antibody levels.
- X-rays of hands, feet and any other severely affected joints.
- Blood tests while taking DMARDs, including a full blood count, liver and kidney tests, inflammation tests, immunity levels and signs of infection.
- ‘Functional assessments’, for example, via the Health Assessment Questionnaire (HAQ), to see how RA affects your everyday life and if treatment is helping.
- Heart tracing (ECG), heart/lung/liver scans and bone-density scans, as appropriate.
E331 – Rheumatoid Arthritis and the Truth About It – www.diabetic.today