Comorbidities

Gouty arthritis rarely exists in isolation; there is a prevalence of gout in patients who have other diseases. Everyone with gouty arthritis has at least one or two of the several comorbidities associated with gout, and many have three or four other health conditions. Once gout is controlled with medication, it’s easier to treat the comorbidities and vice versa. Left untreated, gouty arthritis can progress and lead to permanent bone, joint and tissue damage, even leading to deformities—particularly to the hands and feet—and lead to loss of normal use.

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Underlying Conditions

It’s thought that the underlying uric acid plays a role in renal and cardiovascular disease and hypertension. Gouty arthritis is one of the components we see in the metabolic syndrome where diabetes is the lynchpin of that disease complex.

Gout and Diabetes

It’s thought that the underlying uric acid plays a role in renal and cardiovascular disease and hypertension. Gouty arthritis is one of the components we see in the metabolic syndrome where diabetes is the lynchpin of that disease complex.

Research has shown that there is a link between gout and diabetes, with 26% of gout patients also suffering from diabetes.

Diabetes is a disease in which blood glucose (sugar) levels are above normal, due to either a lack of insulin in the blood or resistance to the insulin. Studies have shown that insulin resistance may play a role in developing gout and that hyperuricemia may worsen insulin resistance. Insulin resistance has also been associated with obesity and high blood pressure, which are risk factors for gout.

Like gout, diabetes has been linked to other serious health issues, such as heart disease and kidney damage. Controlling blood sugar and uric acid levels can help to make both diabetes and gout easier to manage. However, some medications (corticosteroids) make it more difficult to treat a patient with gout and diabetes. With growing concern about using NSAIDs for pain in diabetics with kidney disease because NSAIDs can injure the kidneys, it’s important to schedule a visit with your rheumatologist or other gout specialist who can not only help control healthy benchmarks, but also prescribe the right treatment for you.

While anyone with gout can develop diabetes, risk is especially high among women – with recent studies showing that women who have gout are 47 percent more likely to develop diabetes than women who do not have gout.

Diabetes

Control Gout and Protect Your Long-Term Health

Maintaining a healthy serum uric acid level of 6.0 mg/dL or below is important to reduce risk for gout and diabetes. Ask your doctor for a routine serum uric acid blood test to see if you have elevated uric acid. Your doctor can also run tests to measure your blood sugar level.

If your uric acid levels are high, your doctor may prescribe medications to help keep levels low and reduce your risk for future gout flares. It is important to take these medications as prescribed – and not to stop them without talking with the doctor. It is also important to tell your doctor about all other medications and supplements you are taking, as some may be raising your uric acid levels.

Other steps – such as drinking plenty of water to flush the kidneys and help to remove uric acid from the bloodstream; exercising and maintaining a healthy body weight; and maintaining a diabetes-friendly diet – are also important for reducing risk.

To learn more about gout and diabetes, download this brochure. Additional information about diabetes is available through https://www.diabetes.org/newsroom/press-releases/2012/sci-sessions-TINSAL.html.

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Gout and Heart Disease

Uric acid is a known risk factor for both hypertension and heart disease. Many epidemiological studies show a link between uric acid and coronary disease, including stroke and heart attack. With higher levels of uric acid in the body, it creates an environment for painful gout flares. And those who have gout are more likely to have heart health issues–including heart disease, blocked arteries and heart failure. Left untreated, gout can be very dangerous, with new research showing that having gout doubles a person’s risk for heart attack or stroke.

Uric acid is a normal waste product found in your blood stream – but having more uric acid than the kidneys can get rid of can lead to a condition called hyperuricemia (high uric acid in the blood). High levels of uric acid can cause crystals to form in the joints and other tissues. The inflammation associated with gout can lead to a heart attack or stroke. Though other health issues – such as obesity, high lipid levels, kidney disease and diabetes – can increase your risk for gout and heart problems, research shows that hyperuricemia alone has been linked with a higher risk of death and other heart-related complications.

Flares of gout or inflammation anywhere in the body can worsen heart disease and limits how to treat patients, especially with corticosteroids. Traditional medications like allopurinol can be used, but special care is required with colchicine. Patients and caregivers need to be vigilant for potential side effects, anticipating them and going slowly while using the medications. By visiting a rheumatologist or other gout specialist, you can ensure you’re getting the right treatment for gout and your heart health.

Control Gout and Protect Your Heart Health

Maintaining a healthy serum uric acid level of 6.0 mg/dL or below is important to reduce risk for gout and heart disease. Ask your doctor for a routine serum uric acid blood test to see if you have elevated uric acid. The doctor can also run tests to measure your blood pressure and check your cholesterol levels.

If your uric acid levels are high, your doctor may prescribe medications to keep uric acid levels low and reduce your risk for future gout flares. It is important to take these medications as prescribed – and not to stop them without talking with the doctor. It is also important to tell your doctor about all other medications and supplements you are taking, as some may be raising your uric acid levels.

Other steps–such as drinking plenty of water to flush the kidneys and help to remove uric acid from the bloodstream; exercising and maintaining a healthy body weight; and avoiding trigger foods–are also important for reducing risk.

To learn more about gout and heart health, download this brochure. Additional information about heart health is available through the American Heart Association at heart.org.

Gout and Renal Disease

Those who have gout are more likely to get renal disease – and likewise, those who have renal disease are more likely to suffer from gout and elevated uric acid levels.

Uric acid is a normal waste product that can be found in your blood stream – but when kidneys aren’t functioning well and there’s more uric acid in the bloodstream than the kidneys can get rid of, a condition called hyperuricemia (high uric acid in the blood) can occur. This buildup of uric acid (and elevated UA levels) can cause gout and painful crystals to form around the joints. When kidneys aren’t functioning well, it gets tricky to treat gout in renal disease patients, so close monitoring by a doctor – a rheumatologist or nephrologist – is vitally important. Medications – like probenecid –that help to eliminate uric acid through the kidneys are not effective, and NSAID use for pain is difficult because these drugs can injure the kidneys.

Kidney stones form when uric acid crystals deposit in the kidneys. They are very painful and – if left untreated – can block the urinary tract and result in infection. Research has shown that one in five people with gout will develop kidney stones.

Over time, kidney stones can lead to chronic renal disease. For those who have renal disease, it is more difficult for their kidneys to get rid of uric acid. Untreated renal disease can ultimately lead to kidney failure, or loss of kidney function.

Kidney Diagram

Control Gout and Protect Your Kidneys

Maintaining a healthy serum uric acid level of 6.0 mg/dL or below is important to reduce risk for gout and kidney disease. Ask your doctor for a routine serum uric acid blood test to see if you have elevated uric acid. The doctor can also run tests to measure your kidney function.

 

If your uric acid levels are high, your doctor may prescribe medications to keep uric acid levels low and reduce your risk for future gout flares. It is important to take these medications as prescribed – and not to stop them without talking with the doctor. It is also important to tell your doctor about all other medications and supplements you are taking, as some may be raising your uric acid levels.

Other steps – such as drinking plenty of water to flush the kidneys and help to remove uric acid from the bloodstream; exercising and maintaining a healthy body weight; and avoiding trigger foods – are also important for reducing risk.

To learn more about gout and kidney health, download this brochure. Additional information about kidney health is available through the National Kidney Foundation at Kidney.org/atoz.

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CME Courses

The Gout Education Society believes that continuing education for medical professionals and their staff is crucial when it comes to keeping up with the latest in gout treatment, diagnosis and management.

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ACR Guidelines

In October 2012, the American College of Rheumatology (ACR) published its long anticipated “Guidelines for the Management of Gout.” In September 2015, ACR expanded on the existing guidelines and released new classification criteria about gout.

Education Library Resources - Take a Stand on Gout- Implications of the ACR Guidelines for Gout Management

Gout Education Library

With gout on the rise, it is essential that all patients, especially those touched by gout, are knowledgeable about this serious disease. You can always learn more from your doctor during regular visits. Take a stand on gout!