Rheumatoid arthritis and diabetes,

[owl123]

Hi, I have rheumatoid arthritis and diabetes. The RA is under control with Enbrel and I have been place on insulin for the diabetes. I have so far tried 4 types of insulin but each one caused a flare-up of the RA.

It took over a year to get the RA under control and manageable (over 3 years ago and has been reasonably stable, the odd flare up but that's to be expected), so don't want to change what's working for me in that front.

I (me and the diabetic team) cannot seem to be able to find anything at the moment which will help the diabetes. some of the insulin has made it better but still caused a flare up, and also made it worse plus flare up.

I have been told that they have not seen this happen before

Is there any information out there which might help me or do I have to keep on going through the list of different types of insulin?

thanks for reading this

Tom

[allanah]

Hi Tom. I too was in the same boat. I went to weight management team who were amazing and my endocrinologist put me also on a new drug where you " pee" out the sugar. Maybe worth enquiring to them on your next visit...obviously not all treatments are for everyone .

[owl123 in reply to allanah]

Thanks for the reply, I will discuss this with them next time I see them Tom

[nomoreheels]

Hiya Tom, welcome. I have RD but I don't have diabetes though my h does & also a heart condition, the diabetes became hard to control following his latest surgery. He has type 2 due they think to having acute pancreatitis way back. He, like you, trialled a few different acting insulin(s) & the only one which has been successful to date has been Toujeo SoloStar. Don't know if this is one of the 4 you've trialled? They were a little hesitant to prescribe it initially but after such troubles in getting his bloods sugars down initially he's now generally stable. He still has blips but they are becoming fewer the longer he's been injecting it. Just though it may be one you'd not trialled & thought it was worth mentioning.

I hope you can find a good balance between your meds & stop the flares.

[owl123 in reply to nomoreheels]

Thanks for the reply, I have not had this insulin yet but I think at moment they are just going through a list of them. They say they have not seen this problem before. It's going to take time to get things sorted I think,

Tom

[Biofreak]

Hi owl123. I too am type 1 diabetic but I became diabetic at 21 and am now 63. I was diagnosed with RA in my 40s. I have had many changes in insulin over the years because I think the body metabolism changes over the years. I have never found that insulin changes make my RA flare. I am currently on Novorapid insulin before each meal. Dosage is dependent on how much carbohydrates are in the meal. I also inject lantus in the morning and before bedtime. I test my blood at least 4 times a day to keep control of my blood sugar. Are you sure it's the insulin causing the flare. I still have flares occasionally even though my current RA meds are controlling the inflammation.

[owl123 in reply to Biofreak]

Hi, when I started on treatment, my RA was fine but within 2 days I was having a flare. Stopped taking the meds and it cleared up. Started on a different type and same thing occurred, and its happened everytime. I make sure that all is well with the RA before starting a new type of insulin, and the flare clears when i stop the insulin.

It has the diabetic consultant confused as its never happened before, but everyone is differant.

I am trying to get advice as the medical staff are not sure what's happening. I have also posted this on the diabetic chat page as well

Cheers

Tom

[Biofreak]

What happens to your blood sugar when you stop the insulin. It must go through the roof. I would choose to take the insulin because if you don't, you risk ketoacidosis and coma. I would rather experiment with other RA drugs than insulin. I am surprised your diabetes team allows you to stop it because you risk your life. Please don't stop taking your insulin.

[owl123 in reply to Biofreak]

The blood sugar changes with each insulin I have tried.

The problem with changing the RA drugs is that it took a long time to find something which would work for me, and if I stopped taking it now, I would be unable to go back on it.

I have discussed this with my RA consultant and agreed its the best way forward

[Biofreak in reply to owl123]

So what insulin / tablets are you taking now and how are your blood glucose readings if you don't mind me asking.

[owl123 in reply to Biofreak]

no tablets or insulin at the moment.

readings before last trial of insulin was, morning about 10-12 at night about 18.

after last insulin, morning 14-15 night over 20.

that's how much difference just 2 days of insulin made plus a flare up, swollen fingers and wrists which for me is how a flare starts.

[Biofreak in reply to owl123]

Well Tom you have me baffled. I have never heard of insulin causing flares in all my years living with diabetes. One thing is for sure, you can't carry on like this with high blood sugar and no insulin to bring it down to a controlled level. I hope you will be seeing your diabetes team soon and that you can get it sorted. Best wishes to you.

[owl123 in reply to Biofreak]

Thanks for your reply, it has got the consultants etc baffled as well, which is why I am asking on for any info that may help.

[Biofreak]

I don't think anyone can help you with this other than your diabetes team. I have never heard of this before. Not taking your insulin is a recipe for disaster. I understand your reluctance because you fear being in flare with your RA but being in pain with RA doesn't threaten your life but not taking your insulin does. Back in 1978 when I became ill due to my GP not recognising the onset of diabetes I went undiagnosed for 9 months and by the time I was diagnosed in 1979 I was on the verge of kidney failure, coma and had a urinary tract infection due to constantly high blood sugar with no insulin treatment. I was in hospital for 6 weeks and it took 2 years for me to be stabilized properly on the right dose of insulin. It's a constant balancing act. The complications that can set in with constantly high blood sugar are far more life threatening than RA. I can't tell you what to do other than see your diabetes consultant as soon as possible. I really don't want to frighten you but there must be something they can do to sort this out for you. Keep us posted and best of luck.

[owl123 in reply to Biofreak]

Thanks for your comments,

As for the reluctance of having insulin etc, that's not the case, when I have a flare it can sometimes put me in bed for a few days if not caught in time. The RA has put me in hospital before now due to the pain of a flare.

It's seem to have everyone confused.

Hopefully the next type of insulin will work, I have been told that it will have to be trial and error as they have not seen this before.

[Beth72]

I’m a diabetic on insulin and rheumatoid arthritis and I’m on rheumatoid medication and it plays around with my insulin making my blood sugars dangerously low and flare ups all the time

[owl123]

Hi Beth, Sorry to hear that your problems are similar to mine, but it shows me that I am not the only one having problem between RA and diabetes.

Sometime wish the consultants would talk to each other to try to get things stablised.