The Shocking Link Between Osteoarthritis and Type 2 Diabetes
by Jonathan Wright, MD
Do you have osteoarthritis? If you do, your chances of also having insulin resistance are approximately 75%. And if you have insulin resistance, type 2 diabetes is in your future if you do nothing about it.
To make matters worse, if you have osteoarthritis and a family history of type 2 diabetes also, your chances of developing type 2 diabetes are significantly greater than that!
So if you have osteoarthritis, it’s time to investigate your personal risk of future type 2 diabetes, because you can prevent it—100%– if you find yourself at risk and act now.
Groundbreaking research from the Tahoma Clinic
In the 1980’s, I began observing a correlation between osteoarthritis and family history of type 2 diabetes. By the 1990’s, I started recommending routine insulin resistance testing for individuals with osteoarthritis. Better than 50 percent were positive (though no exact records were kept).
Most noticeably, the younger the individual with osteoarthritis, the more likely he or she was to be insulin resistant, which allowed many of these individuals to prevent type 2 diabetes entirely.
So when a respected medical foundation funded research at the Tahoma Clinic about the control of osteoarthritic symptoms with niacinamide, they also allowed us to include insulin resistance testing. The insulin resistance testing was done as detailed by Dr. Joseph Kraft in his landmark study of over 3,500 such tests, published in 1976. (For the technically inclined, Dr. Kraft’s research report is downloadable for free here.)
Fifty-eight of the 59 individuals who completed the study had their insulin tested. Of the 58 individuals (all of whom had osteoarthritis), 81.1 percent had insulin abnormalities. Forty-four (75.7 percent) were found to have insulin resistance, and three (5.4 percent) had gone past insulin resistance to an abnormally low insulin response, which can ultimately result in type 1 (low or no insulin) diabetes. Only 11 (18.9 percent) did not have insulin abnormalities.
As many readers know, insulin resistance is a hallmark of metabolic syndrome, which includes abdominal obesity along with high blood lipids (cholesterol, triglycerides) and/or high blood pressure.
If untreated, metabolic syndrome deteriorates into type 2 diabetes, which often deteriorates further to kidney failure (approximately half of all dialysis patients are diabetic), heart attack, stroke, and varying degrees of visual impairment, even blindness.
Research confirms osteoarthritis/ metabolic syndrome link
The research done at the Tahoma Clinic by Drs. John Sherman and David Zeoli is one of the first to confirm that osteoarthritis is another aspect of metabolic syndrome by actually testing insulin resistance. Using other data, other researchers have published four previous research papers that have come to the same conclusion.
The first of these was published in 2007. The researchers reported that individuals with osteoarthritis and metabolic syndrome developed symptoms of osteoarthritis at an earlier age, had greater generalized disease, developed knee joint synovitis and periarthritis, and had more intensive joint pain.
In 2008, the same researchers reported that of 1,350 individuals with osteoarthritis, complete metabolic syndrome occurred in 62.5 percent. Neither group (nearly 20 percent) was found to have some but not all features of metabolic syndrome, for a total of 82.1 percent with complete or partial metabolic syndrome. These researchers also measured a marker of inflammation called C-Reactive Protein (CRP), and found that higher levels of CRP were associated with greater degrees of osteoporosis.
The 2007 and 2008 studies were done by the same group in Russia.
In 2009, two researchers examined data from the 7,714 individuals enrolled in the National health and Nutrition Examination Survey lll (NHANESlll). Of the 975 individuals who had osteoarthritis, 59 percent had metabolic syndrome, while only 23 percent of the individuals without osteoarthritis had metabolic syndrome.
As I’ve observed in practice for years, they reported that the association between metabolic syndrome and osteoarthritis was stronger in younger individuals and diminished with increasing age. In their data, having osteoarthritis at 43 to 44 years of age was associated with a 500 percent increased risk of metabolic syndrome
Last year (2010), in a review article titled, “Osteoarthritis: another component of metabolic syndrome?” the researchers wrote: “There is growing evidence that osteoarthritis is not simply a disease related to aging or mechanical stress of joints but rather a metabolic disorder…”
And this year—Drs. Sherman and Zeoli have found that approximately 75 percent of osteoarthritic individuals are insulin resistant, approximately 5 percent have gone past insulin resistance to early pancreatic islet cell exhaustion (in English, the cells that make insulin are getting worn out) and ultimately type 1 diabetes, and only about 20 percent of individuals with osteoarthritis did not have insulin abnormalities.